Active NPI
Cynthia Crandall, PSY.D
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1023030418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP4201
- Practice address
- 3133 Hennepin Ave
Minneapolis, MN 55408-2620 - Phone
- (612) 803-7368
- Fax
- (612) 823-3161
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4201 | MN | Primary |
Addresses
Primary practice location
3133 Hennepin Ave
Minneapolis, MN 55408-2620
Mailing address
3133 Hennepin Ave
Minneapolis, MN 55408-2620
Phone (612) 803-7368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4201 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023030418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3133 HENNEPIN AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082620",
"telephone_number": "612-803-7368",
"fax_number": "612-823-3161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3133 HENNEPIN AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082620",
"telephone_number": "612-803-7368",
"fax_number": "612-823-3161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "CYNTHIA",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.