WALTER O BOCKTING


Address: 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075
Phone: 6126251500

WALTER O BOCKTING (NPI# 1104901172) 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) 1104901172
Entity Type Individual
Full Name WALTER O BOCKTING
Credential PHD
Practice Address 1300 S 2nd St
Suite 180
Minneapolis
MN 55454-1075
Mailing Address 3989 Central Ave Ne
Suite 300
Columbia Heights
MN 55421-3900
Practice Telephone 6126251500
Mailing Telephone 6126251500
Enumeration Date 2006-10-26
Last Update Date 2008-07-07
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist LP2505 MN Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
LP2505 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN PREFERREDONE 1007664 01
MN BLUE CROSS BLUE SHIELD 602T9BO 01
MN UCARE 102450 01
MN MEDICA - CHOICE 61-81256 01
MN HEALTHPARTNERS HP50070 01
MN 048313300 05

Office Location

Street Address 1300 S 2ND ST
SUITE 180
City MINNEAPOLIS
State MN
Zip Code 55454-1075

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245349257 Russell Vincent Luepker General Acute Care Hospital 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 2006-08-30
1083065080 Rachel Becker-warner Psychologist 1300 S 2nd St, Minneapolis, MN 55454-1075 2016-06-30
1437583481 Brenna M Wernersbach Counselor 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2013-08-27
1124452404 Rebecca Stinson Psychologist 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2013-08-22
1407129786 Brad Ryan Nederostek Psychologist 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2012-02-16
1073845079 Katherine G Spencer Psychologist 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2010-02-02
1730265844 Rosemary Ann Munns Psychologist 1300 S 2nd St, Ste 180, Minneapolis, MN 55454-1075 2006-10-31
1598840688 Sara Jane S Mize Psychologist 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2006-10-26
1487739827 Michael H Miner Psychologist 1300 S 2nd St, Suite 180, Minneapolis, MN 55454-1075 2006-10-26
1902980782 Joan M Patterson Psychologist 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 2006-10-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194341842 Bruce Zhang Student in an Organized Health Care Education/Training Program 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 2020-06-18
1205456738 Sara Segner Student in an Organized Health Care Education/Training Program Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 2020-04-24
1417576844 Sabena Khan Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 2020-04-15
1811525983 Kayla Joy Solstad Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 2020-04-01
1720647126 Lauren Harasymiw Student in an Organized Health Care Education/Training Program Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 2019-06-10
1689237448 Katelyn Marie Adams Student in an Organized Health Care Education/Training Program Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 2019-04-17
1285197848 Adrienne Bruder Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 2019-04-10
1588142855 Stewart Graeme Morrison Student in an Organized Health Care Education/Training Program Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 2018-07-30
1831682251 Sherab Tsheringla Student in an Organized Health Care Education/Training Program 2450 Riverside Avenue South, Minneapolis, MN 55454 2018-06-11
1669962148 Pooja Elizabeth Mishra Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 2018-05-10
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861008567 Natalia V Potapova Psychologist 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 2020-09-17
1962014167 Kate Esterline Psychologist 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 2020-08-19
1831740216 Seth Gordon Disner Psychologist 1 Veterans Dr # B68-2, Minneapolis, MN 55417-2309 2019-09-26
1366090763 Healing Therapy LLC Psychologist 1813 S 6th St Ste 201, Minneapolis, MN 55454-1208 2019-08-28
1891340469 Karin Fisher Psychologist 701 Park Ave # S1.260, Minneapolis, MN 55415-1623 2019-08-09
1053881698 Lauren Michelle Scholder Psychologist 401 Main St Se Apt 7009, Minneapolis, MN 55414 2018-11-27
1902306038 Ksa Psychological Services, LLC Psychologist 5603 Chicago Ave., Minneapolis, MN 55417 2018-02-15
1689030231 Oliver Ross Psychology and Consulting LLC Psychologist 3802 Grand Ave S, Suite A, Minneapolis, MN 55409-1233 2016-01-13
1295100881 Oliver Ross Psychologist 3802a Grand Avenue South, Minneapolis, MN 55409 2015-12-08
1841664190 Lakes Wellness Center LLC Psychologist 3248 Stevens Ave, Minneapolis, MN 55408-3214 2015-11-24
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Competitor

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City MINNEAPOLIS
Zip Code 55454

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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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