Individual provider Active NPI

Stephanie Lynn Bauer, SCHOOL PSYCHOLOGIST

  • School Psychologist
  • Forest Lake, MN
National Provider Identifier
1053252163
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
437779 Issued in MN
Practice address
6100 210TH St N
Forest Lake, MN 55025-9617
Phone
(651) 982-8652
NPI assigned
Apr 2, 2026
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 437779 MN Primary

Addresses

Primary practice location

6100 210TH St N
Forest Lake, MN 55025-9617

Mailing address

6100 210TH St N
Forest Lake, MN 55025-9617

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

LicenseStateTypeSpecialty
437779MNMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1053252163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 210TH ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 210TH ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259617",
            "telephone_number": "651-982-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "SCHOOL PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "437779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.