Active NPI
Jennifer Sarah Mrnak-Meyer, PH.D., L.P.
- Clinical Psychologist
- Saint Cloud, MN
National Provider Identifier
1033408943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5393
- Practice address
- 4801 Veterans Dr
Saint Cloud, MN 56303-2015 - Phone
- (320) 252-1670
- Fax
- (320) 255-6378
- NPI assigned
- Mar 31, 2011
- Sex
- Female
- Sole proprietor
- No
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 | LP5393 | MN | Primary |
Addresses
Primary practice location
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Mailing address
1335 Cooper Ave S
Saint Cloud, MN 56301-4826
Phone (618) 303-7573
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5393 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1033408943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1335 COOPER AVE S",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563014826",
"telephone_number": "618-303-7573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 VETERANS DR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032015",
"telephone_number": "320-252-1670",
"fax_number": "320-255-6378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MRNAK-MEYER",
"first_name": "JENNIFER",
"middle_name": "SARAH",
"name_prefix": "Dr.",
"credential": "PH.D., L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-31",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.