Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kerry Ryan Brockberg, PHD, LP

Individual provider Psychologist · NPI 1588179410

Dr. Kerry Ryan Brockberg, PHD, LP is a Clinical Psychologist in Minneapolis, Minnesota. Graduated from University of Wisconsin School of Medicine in 2017, 9 years ago. Practices with Allina Health System, a 3,867-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
9
Trained at
University of Wisconsin School of Medicine
Licensed in
MN
In the registry since
2017
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

11850 Blackfoot St NW Ste 405
Minneapolis, MN 55433-2773
Phone: (763) 236-0888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP6410 (MN)

Record details

NPI number1588179410
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD , LP
Sole proprietorNo
NPI enumeratedDecember 14, 2017
Last updated in NPPESMay 18, 2021
Certification dateMay 18, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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