Lisa Marie Fedora, M.A., L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP4660 Issued in MN

Practice address

11 E Superior St Ste 415
Duluth, MN 55802-3008

Phone

(218) 249-0595

Fax

(218) 461-3666

NPI assigned

Dec 28, 2006

Last updated

Mar 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arrowhead Psychological Clinic, P.a.Group PAC ID 4880629633, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Arrowhead Psychological Clinic, P.a.

  • Clinical Psychologist
  • Duluth, MN
  • NPI 1619032562
  Medicare reassignment Care Compare group NPD
• Duluth Counseling Center

  • Community/Behavioral Health Agency
  • Duluth, MN
  • NPI 1679815823
  Medicare reassignment NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1023174638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E SUPERIOR ST STE 415",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558023008",
            "telephone_number": "218-249-0595",
            "fax_number": "218-461-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E SUPERIOR ST STE 415",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558023008",
            "telephone_number": "218-249-0595",
            "fax_number": "218-461-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Nell Featherston, PA-C
• Stephanie Fechner, LICSW
• Federal Prison Camp Duluth
• Annette Lynn Fedler, LPN
• Angela Fedo
• Nicole Feehery-Alpuerto, MS, CNS, LN
• Lisa Marie Feikema
• Kristine Marie Feiro, PHARM.D.
• Ian Christopher Fekete, MD
• Elaheh Fekrazad

• Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.