Individual provider Active NPI

Colleen Doyle, PHD, LP

  • Clinical Child & Adolescent Psychologist
  • Minneapolis, MN
National Provider Identifier
1992583181
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
LP6975 Issued in MN
Practice address
2312 S 6TH St FL 2
Minneapolis, MN 55454-1336
Phone
(612) 273-8700
Fax
(612) 273-9774
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP6975 MN
Health Service Psychologist 103TH0100X LP6975 MN
Clinical Child & Adolescent Psychologist 103TC2200X LP6975 MN Primary

Addresses

Primary practice location

2312 S 6TH St FL 2
Minneapolis, MN 55454-1336

Mailing address

2312 S 6TH St FL 2
Minneapolis, MN 55454-1336

Other practice location 1

2025 E River Pkwy
Minneapolis, MN 55414-3604
Phone (612) 301-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010001573 MN Practitioner - Clinical Psychologist 7618322710 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP6975MNMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Nov 15, 2023 Accepting new patients
Fairview Express Care CurrentSince Nov 15, 2023 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 7, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 7, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 7, 2024 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Nov 15, 2023 Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2450 Riverside Ave
Fl 2A
Minneapolis, MN 55454

2025 E River Rd
Minneapolis, MN 55414
Phone (612) 301-0115

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2312 S 6th St
Fl 2
Minneapolis, MN 55454
Phone (612) 273-8700

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1992583181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 S 6TH ST FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 S 6TH ST FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541336",
            "telephone_number": "612-273-8700",
            "fax_number": "612-273-9774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 E River Pkwy",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554143604",
            "country_code": "US",
            "telephone_number": "612-301-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6975",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MN",
            "license": "LP6975",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP6975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.