Individual provider Active NPI

William Willard Pace, PH.D., L.P.

  • Clinical Psychologist
  • Golden Valley, MN
National Provider Identifier
1093724049
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP2543 Issued in MN
Practice address
5851 Duluth St
Suite 113
Golden Valley, MN 55422-3946
Phone
(651) 645-3115
Fax
(651) 645-2752
NPI assigned
Aug 7, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X LP2543 MN
Clinical Psychologist 103TC0700X LP2543 MN Primary

Addresses

Primary practice location

5851 Duluth St
Suite 113
Golden Valley, MN 55422-3946

Mailing address

5851 Duluth St
Suite 113
Golden Valley, MN 55422-3946
Phone (651) 645-3115

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Psychology Consultants PA Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093724049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "SUITE 113",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "651-645-3115",
            "fax_number": "651-645-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "SUITE 113",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "651-645-3115",
            "fax_number": "651-645-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "WILLIAM",
        "middle_name": "WILLARD",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP2543",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.