DR. CASEY LEE MCDOUGALL (NPI# 1548563620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548563620 |
| Entity Type | Individual |
| Full Name | DR. CASEY LEE MCDOUGALL |
| Credential | PH.D., L.P. |
| Practice Address |
Hwy 1 Hospital Drive Box 497 Red Lake MN 56671 |
| Mailing Address |
Box 497 Hwy 1 Ave Red Lake MN 56671 |
| Practice Telephone | 2186793912 |
| Practice Fax Number | 2186790181 |
| Mailing Telephone | 2186793912 |
| Mailing Fax Number | 2186790181 |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2012-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | LP 5341 | MN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP 5341 | MN | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
LP 5341 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1508809765 | 05 | |
| MN | MN BOARD OF PSYCHOLOGY LICENSE # | LP 5341 | 01 |
| Street Address |
HWY 1 HOSPITAL DRIVE BOX 497 |
| City | RED LAKE |
| State | MN |
| Zip Code | 56671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033140561 | Gregory S Anderson | General Practice | Hwy 1 Hospital Drive, Box 497, Red Lake, MN 56671-0497 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
| 1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
| 1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
| 1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| Find all providers in zip 56671 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899291 | Charlotte Mae Gerth Haanen | Psychologist | 2805 Cliff Rd E, Burnsville, MN 55337-4095 | 2020-10-17 |
| 1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1720691884 | Oluwatosin Alabi | Psychologist | 4124 Quebec Ave N Ste 307, New Hope, MN 55427-1241 | 2020-08-28 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
| 1699392266 | Jacqueline Suresh Layton | Psychologist | 17324 Glencoe Ave, Lakeville, MN 55044-7429 | 2020-06-30 |
| 1760016109 | Cori Miller | Psychologist | 7300 Metro Blvd Ste 400, Edina, MN 55439-2307 | 2020-02-25 |
| 1831722594 | Collaboration for Psychological Wellness, LLC | Psychologist | 12000 Portland Ave Ste 120, Burnsville, MN 55337-4469 | 2020-02-20 |
| 1780214601 | Jennifer Jacqueline Felinski Kurtz | Psychologist | 16688 Kentucky Ave, Lakeville, MN 55044-4616 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.