Active NPI
Paula J Pitterle, PHD LP
- Clinical Child & Adolescent Psychologist
- Minneapolis, MN
National Provider Identifier
1962476655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- LP4646
- Practice address
- 2525 Chicago Ave South
Childrens Specialty Clinic - Psychological Services
Minneapolis, MN 55404 - Phone
- (612) 813-8455
- Fax
- (612) 813-8263
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | LP4646 | MN | Primary |
Addresses
Primary practice location
2525 Chicago Ave South
Childrens Specialty Clinic - Psychological Services
Minneapolis, MN 55404
Mailing address
2910 Centre Pointe Dr
35-121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4646 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1962476655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 CENTRE POINTE DR",
"address_2": "35-121A CHILDRENS HEALTH CARE",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-855-2109",
"fax_number": "651-855-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE SOUTH",
"address_2": "CHILDRENS SPECIALTY CLINIC - PSYCHOLOGICAL SERVICES",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55404",
"telephone_number": "612-813-8455",
"fax_number": "612-813-8263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTERLE",
"first_name": "PAULA",
"middle_name": "J",
"credential": "PHD LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "LP4646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.