1891858874 NPI number — DR. DOROTHEE M ISCHLER DMFT, LMFT

Table of content: DR. DOROTHEE M ISCHLER DMFT, LMFT (NPI 1891858874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891858874 NPI number — DR. DOROTHEE M ISCHLER DMFT, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ISCHLER
Provider First Name:
DOROTHEE
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMFT, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAKER
Provider Other First Name:
DOROTHEE
Provider Other Middle Name:
ISCHLER
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMFT, LMFT, LP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891858874
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 DIVISION ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHFIELD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55057-2046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-210-4984
Provider Business Mailing Address Fax Number:
507-645-6151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3601 MINNESOTA DR STE 170
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLOOMINGTON
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55435-5202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-924-3807
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  701 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT701 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6220344 . This is a "UBH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP20384 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7972201025212 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9H005IS . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 692252000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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