Individual provider Active NPI

Peter Andrew Lynn, PH.D., L.P.

  • Clinical Psychologist
  • West St Paul, MN
National Provider Identifier
1093486110
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6702 Issued in MN
Practice address
149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238
Phone
(651) 450-0860
Fax
(651) 450-0759
NPI assigned
Sep 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP6702 MN Primary

Addresses

Primary practice location

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

Other practice location 1

7066 Stillwater Blvd N
Oakdale, MN 55128-3937
Phone (651) 251-5213

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
I20211228001885 MN Practitioner - Clinical Psychologist 3274924378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arcs Institute LLCGroup PAC ID 2961847785, 2 clinicians

Practice addresses (Care Compare)

30 1St Ave NE
Suite 11
Buffalo, MN 55313-1515
Phone (651) 243-0619

825 Nicollet Mall
Suite 1946
Minneapolis, MN 55402-2707
Phone (651) 243-0619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP6702MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arcs Institute LLC Clinical CurrentSince Feb 1, 2026 Accepting new patients
Canvas Health, Inc. CurrentSince Sep 24, 2021 Accepting new patients

Locations

30 1st Ave NE
Ste 11
Buffalo, MN 55313
Phone (651) 243-0619

825 Nicollet Mall
Ste 1946
Minneapolis, MN 55402
Phone (612) 339-1463

7066 Stillwater Blvd N
Saint Paul, MN 55128

375 Orleans St E
Stillwater, MN 55082
Phone (651) 430-2720

Organizations & group practices 2

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1093486110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7066 Stillwater Blvd N",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "MN",
            "postal_code": "551283937",
            "country_code": "US",
            "telephone_number": "651-251-5213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNN",
        "first_name": "PETER",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

Verify at the official NPI Registry.