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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP6071 | MN | Behavioral Health & Social Service Providers |
| Street Address |
1540 LAKE ST S |
| City | FOREST LAKE |
| State | MN |
| Zip Code | 55025-2628 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 55025 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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] |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FOREST LAKE |
| Zip Code | 55025 |
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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.