Individual provider Active NPI

Mary Clare B Lindsley, PSYD, LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1043970338
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP6738 Issued in MN
Practice address
2435 Como Ave
Saint Paul, MN 55108-1459
Phone
(651) 300-2387
NPI assigned
Dec 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP6738 MN
Psychologist 103T00000X LP6738 MN Primary

Addresses

Primary practice location

2435 Como Ave
Saint Paul, MN 55108-1459

Mailing address

2435 Como Ave
Saint Paul, MN 55108-1459
Phone (651) 300-2387

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
I20220107002101 MN Practitioner - Clinical Psychologist 2860884566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2435 Como Ave
Saint Paul, MN 55108-1459
Phone (651) 300-2387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP6738MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Clare Lindsley, LLC CurrentSince Jul 19, 2024 Accepting new patients

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": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1043970338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081459",
            "telephone_number": "651-300-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081459",
            "telephone_number": "651-300-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSLEY",
        "first_name": "MARY CLARE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP6738",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.