DR. KATHRYN LEE ISHAM


Address: 1540 Lake St S, Forest Lake, MN 55025-2628
Phone: 6514647100

DR. KATHRYN LEE ISHAM (NPI# 1023551702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023551702
Entity Type Individual
Full Name DR. KATHRYN LEE ISHAM
Credential L.P.
Practice Address 1540 Lake St S
Forest Lake
MN 55025-2628
Mailing Address 2925 Chicago Ave
Minneapolis
MN 55407-1321
Practice Telephone 6514647100
Mailing Telephone 6122625000
Enumeration Date 2016-11-29
Last Update Date 2017-05-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist LP6071 MN Behavioral Health & Social Service Providers

Office Location

Street Address 1540 LAKE ST S
City FOREST LAKE
State MN
Zip Code 55025-2628

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104808534 C Scott Kammer Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2005-11-20
1366049975 Nicole M Arndt-wenger Social Worker 1540 Lake St S, Forest Lake, MN 55025-2628 2020-10-06
1760774574 Kelsey Lee Hultman Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2011-05-11
1619266608 Benjamin Dashiell Lambertson Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2011-03-31
1447556261 Allina Health System Clinic/Center 1540 Lake St S, Forest Lake, MN 55025-2628 2011-01-27
1487889929 Brita Lara Wegener Physician Assistant 1540 Lake St S, Forest Lake, MN 55025-2628 2009-05-28
1023252731 Oluwakemi Tinuke Olowoyo Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2009-04-24
1306011416 Brett J Salek Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2008-04-29
1033393178 Vivian Lilly Wireko-brobby Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2007-12-26
1255479879 Steven Duane Semmler Family Medicine 1540 Lake St S, Forest Lake, MN 55025-2628 2007-02-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043846173 Persistence Physical Therapy LLC Clinic/Center 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 2020-03-20
1255973319 Connie Rettig Technician 908 North Shore Drive, Forest Lake, MN 55025 2019-10-10
1003394479 Malissa Ann Costanzo Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 844 8th Ave Se, Forest Lake, MN 55025 2018-07-30
1669754735 Brent Alan Millard Pharmacist 1207 West Broadway Ave, Forest Lake, MN 55025 2011-09-15
1982842167 Lakes Center for Youth and Families Community/Behavioral Health 20 N Lake Street, Suite 103, Forest Lake, MN 55025 2009-01-27
1487843355 Paul Luke Mladnick Marriage & Family Therapist 1068 So Lake St, #109, Forest Lake, MN 55025 2007-10-17
1740477678 Rita Lynn Scanlan Occupational Therapist 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 2007-09-25
1114053113 Senior Care Forest Lake, LLC Skilled Nursing Facility 604 N.e. First Street, Forest Lake, MN 55025 2007-02-26
1073672101 Catharine B Ruther Dentist 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 2006-12-06
1407914849 Ervin George Savord Dentist 255 Highway 97, Suite 1b, Forest Lake, MN 55025 2006-12-05
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316400740 Susan Hoisington Counseling LLC Psychologist 1068 Lake St S Ste 102, Forest Lake, MN 55025-2633 2019-04-11
1083717433 Joseph James Bauer Psychologist 1068 S. Lake St. #109, Forest Lake, MN 55025 2006-09-07
1669491361 Louisa Hollinshead Psychologist 121 11th Ave Se, Forest Lake, MN 55025-1850 2006-07-19
1043302987 Cathy Lee Skrip Psychologist 20 Lake St N, Suite 308, Forest Lake, MN 55025-2523 2006-09-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801493952 Michelle Brownfield Psychologist 606 Spear Ave, Duluth, MN 55803-2154 2020-10-01
1730716994 Tamolyn Patterson Benke Psychologist 8453 Casey Ct, Inver Grove Heights, MN 55076-5154 2020-03-26
1407496516 Liza N Meredith Psychologist Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 2020-01-07
1134764871 Avital Ogniewicz Psychologist 2519 Commerce Dr Nw, Rochester, MN 55901-4432 2019-11-15
1164065868 Karen Nicole Chinnock Psychologist 930 Blue Gentian Rd, Eagan, MN 55121-1674 2019-10-25
1194368191 Luz Angelica Fehn Salinas Psychologist 1315 E24th St, Minneapolis, MN 55404 2019-10-22
1083257349 Nathaniel Page Psychologist 2423 Valley Dr, Northfield, MN 55057-3224 2019-10-18
1639711492 Ismahan Abdirahman Mohamed Psychologist 4236 Parkglen Rd, St Louis Park, MN 55416 2019-10-14
1164071148 Amy C Moran Psychologist Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 2019-09-11
1881243590 Bill Clafton Psyd Lp LLC Psychologist 1755 Old West Main St Ste 204, Red Wing, MN 55066-3057 2019-09-05
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Competitor

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City FOREST LAKE
Zip Code 55025

Improve Information

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Dataset Information

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.

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