Lisa Marie Anderson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6534 Issued in MN

Practice address

9600 Upland LN N Ste 110
Maple Grove, MN 55369-4499

Phone

(952) 993-6200

NPI assigned

Mar 25, 2021

Last updated

Oct 30, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Express Care

  • Medical Specialty Clinic/Center
  • Edina, MN
  • NPI 1538599790
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  dba University of Minnesota Health Clinics and Surgery Center - Anesthesia

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  dba M Physicians Mill City Clinic

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1124274527
  NPD
• University of Minnesota Physicians

  dba Dental Clinic

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1114504123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N STE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694499",
            "telephone_number": "952-993-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5775 Wayzata Blvd Ste 255",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554161275",
            "country_code": "US",
            "telephone_number": "952-525-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anderson, LMFT
• Jordan Lillian Anderson, PA-C
• Joy Nieves Anderson, RD
• Kaitlyn Anderson
• Kellan J Anderson
• Lora Lee Anderson, LPT
• Morgan Renae Anderson
• Rachael Teresa Anderson, RN, APRN
• Vandi Jo Anderson, PHARMD
• Andrea Rude

• Clinical Psychologist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.