Dr. Miranda Dyrdahl
Dr. Miranda Gilmore · Psychologist (Clinical)

Address: 3333 University Ave Se, Minneapolis, MN 55414
Phone: 7632337278

Dr. Miranda Dyrdahl (NPI# 1114148798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1114148798
Entity Type Individual
Full Name Dr. Miranda Dyrdahl
Other Name Dr. Miranda Gilmore
Credential PSY.D., LMFT, LP
Gender Female
Practice Address 3333 University Ave Se
Minneapolis
MN 55414
Practice Telephone 7632337278
Mailing Address 3333 University Ave Se
Minneapolis
MN 55414-3325
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2007-05-01
Last Update Date 2018-08-21

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 103T00000X Psychologist Behavioral Health & Social Service Providers RPS2010006 CA
No 103TC0700X Psychologist · Clinical Behavioral Health & Social Service Providers GL0006 MN
No 103TC0700X Psychologist · Clinical Behavioral Health & Social Service Providers PSY24149 CA
No 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers 2599 MN
No 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers 46860 CA
No 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers 51386 CA
Yes 103TC0700X Psychologist · Clinical Behavioral Health & Social Service Providers LP5423 MN

Secondary Practice Locations

Address Telephone Number Fax Number
2829 Verndale Ave, Anoka, MN 553031620 7632237278

Physician Overview

NPI 1114148798
PAC ID by PECOS 3476863895
Professional Enrollment ID I20151113001442
Full Name Miranda Jean Gilmore
Organization Legal Name THERAPEUTIC SERVICES AGENCY INC
Phone Number 3206297600
Gender F
Graduation Year 2009
Primary Specialty CLINICAL PSYCHOLOGIST
Group Practice PAC ID 4981877891
Number of Group Practice Members 3
Accepts Medicare Assignment Y

Office Location

Street Address 3333 UNIVERSITY AVE SE
City MINNEAPOLIS
State MN
Zip Code 55414

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578034856 Nicole Elizabeth Doerrmann Counselor 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-12-11
1992284467 Emma Rose Kosciolek Counselor 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-08-07
1568949535 Amy Elizabeth Mckinley Counselor 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-07-23
1285120550 Jordan Brandt Counselor 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-07-10
1356837074 Kristina Marie Schoessler Occupational Therapist 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-07-05
1083106447 John David Hoch Psychologist 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-06-01
1710474226 Sua Cha Marriage & Family Therapist 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-04-19
1760986657 Jessica Ann Leschak Social Worker 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-03-23
1265935076 Monica Lynn Sharratt Social Worker 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-03-18
1851809172 Jennifer Ann Voss Social Worker 3333 University Ave Se, Minneapolis, MN 55414-3325 2018-01-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053881698 Lauren Michelle Scholder Psychologist 401 Main St Se Apt 7009, Minneapolis, MN 55414 2018-11-27
1427530666 Kelli Howard Psychologist 2724 University Ave Se Unit B, Minneapolis, MN 55414 2018-09-04
1306370218 Jiexiong Yang Student in an Organized Health Care Education/Training Program 814 Essex St Se, Minneapolis, MN 55414 2017-04-18
1598297699 Patrick Curran Student in an Organized Health Care Education/Training Program 628 University Ave Se, Apt. 112, Minneapolis, MN 55414 2017-03-29
1679923957 Jillian Theresa Tholen Dietitian, Registered 411 E Hennepin Ave, Minneapolis, MN 55414 2016-06-16
1073960290 First Language Interpreter & Translation Services LLC Interpreter 2828 University Ave Se Suite 150, Minneapolis, MN 55414 2016-05-17
1447669916 Alberto Herrero Babiloni Student in an Organized Health Care Education/Training Program 19 27th Ave Se Apt 304, Minneapolis, MN 55414 2014-08-08
1023450772 Erika Marie Haglund Pharmacist 1329 5th St Se, T-3200, Minneapolis, MN 55414 2013-07-23
1669717898 Wayne Anthony Washington II Adult Companion 1524 Morgan Ave N, Minneapolis, MN 55414 2012-11-28
1588920490 Ingrid L. Bloom Acupuncturist 2829 University Ave, Suite 400, Minneapolis, MN 55414 2012-04-04
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Taxonomy Information

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

Taxonomy Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Notes: Source: American Psychological Association, www.apa.org [1/1/2019: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1215307046 Danielle Stewart Psychologist 1315 E 24th St, Minneapolis, MN 55404 2015-10-06
1225408826 Vang Xiong Skibbie Psychologist 730 S 8th Street, Purple Building, Level 7, Minneapolis, MN 55415 2015-09-25
1235532615 Joshua Weiler Psychologist 2318 Park Ave S, Minneapolis, MN 55404-3712 2014-09-30
1861801557 Vanessa Rempel Phd, Licensed Psychologist, LLC Psychologist 3011 36th Ave S, Sutie 19, Minneapolis, MN 55406-2124 2014-08-06
1316389562 Danielle Vrieze Psychologist 2450 Riverside Ave Ste 2a, Minneapolis, MN 55454-1450 2013-07-29
Find all providers in MINNEAPOLIS

Competitor

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City MINNEAPOLIS
Zip Code 55414

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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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