Stephanie Untiedt, PHD, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4599 Issued in MN

Legal business name

STEPHANIE UNTIEDT, PHD, LLC

Practice address

5101 Olson Memorial Hwy Ste 4007
Golden Valley, MN 55422-5164

Phone

(763) 595-7294

Fax

(763) 595-7293

NPI assigned

Feb 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Ann Untiedt, PHDNPI 1093756041

Title

Pscyhologist

Phone

(763) 595-7294

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Ann Untiedt, PH.D., L.P.

  • Counseling Psychologist
  • Minneapolis, MN
  • NPI 1093756041
  NPD (past) Authorized official

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

{
    "created_epoch": "1422748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422748800000",
    "number": "1073903886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 OLSON MEMORIAL HWY STE 4007",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225164",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 OLSON MEMORIAL HWY STE 4007",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225164",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE UNTIEDT, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-01",
        "last_updated": "2015-02-01",
        "status": "A",
        "authorized_official_last_name": "UNTIEDT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSCYHOLOGIST",
        "authorized_official_telephone_number": "763-595-7294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093756041",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Stavenger, DPT
• Andrew Steck
• Jeffrey Allyn Steele, DDS
• Darcy Steinhaus, LICSW
• Gregg Thomas Stenger
• Nicholas William Stephens, LICSW
• Stephanie Nicole Stewart, MA, LPCC
• Robert Harrison Stillman, LMFT
• Mara Marie Stommes, MA
• Erin Catherine Stoneking, APRN, CNP

• Mental Health Counselor in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2015; 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.