Individual provider Active NPI

Amanda Mulfinger

  • Clinical Psychologist
  • Edina, MN
National Provider Identifier
1003054545
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5029 Issued in MN
Practice address
7301 Ohms LN Ste 450
Edina, MN 55439-2339
Phone
(952) 831-2000
Fax
(952) 835-6134
NPI assigned
Jan 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 5029 MN Primary

Addresses

Primary practice location

7301 Ohms LN Ste 450
Edina, MN 55439-2339

Mailing address

7301 Ohms LN Ste 450
Edina, MN 55439-2339
Phone (952) 831-2000

Other identifiers 1

IdentifierTypeStateIssuer
LP5029OtherMNMINNESOTA BOARD OF PSYCHOLOGY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000629 MN Practitioner - Clinical Psychologist 9931256286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Cabot Psychological Services, PLLCGroup PAC ID 9739203167, 13 clinicians

Practice addresses (Care Compare)

7301 Ohms LN
Suite 450
Edina, MN 55439-2339
Phone (952) 831-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5029MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cabot Psychological Services, PLLC CurrentSince Jun 29, 2010 Accepting new patients

Locations

7301 Ohms Ln
Ste 450
Minneapolis, MN 55439
Phone (952) 831-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1003054545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 OHMS LN STE 450",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392339",
            "telephone_number": "952-831-2000",
            "fax_number": "952-835-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 OHMS LN STE 450",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392339",
            "telephone_number": "952-831-2000",
            "fax_number": "952-835-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULFINGER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF PSYCHOLOGY",
            "identifier": "LP5029",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.