Mary L. Wandrei, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4875 Issued in MN

Practice address

4325 Virginia Ave
Shoreview, MN 55126-2381

Phone

(651) 755-7875

NPI assigned

Feb 5, 2008

Last updated

Feb 5, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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

State licenses

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.

• Wandrei Psychological Services

  • Clinical Psychologist
  • White Bear Lake, MN
  • NPI 1043093636
  NPD Authorized official
• Dynamic Connections, Inc.

  • Cognitive & Behavioral Psychologist
  • Maplewood, MN
  • NPI 1265791503
  Medicare reassignment
• Affiliated Counseling Center

  • Psychologist
  • Fridley, MN
  • NPI 1194836064
  NPD (past)
• Aria Counseling Assessment and Mediation Centers PLLC

  • Psychologist
  • Fridley, MN
  • NPI 1649613837
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1124206818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 VIRGINIA AVE",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262381",
            "telephone_number": "651-755-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 VIRGINIA AVE",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262381",
            "telephone_number": "651-755-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDREI",
        "first_name": "MARY",
        "middle_name": "L.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MN",
            "license": "4875",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4875",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "4875",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "4875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lyn Vevea, RD LD CDE
• Seth A Vogel, M.D.
• Sarah Vosen, L.AC.
• Jamie Waldvogel
• Laurel Ann Walsh, LMFT
• Abdi Mohamed Warsame
• Azra Weber, M.D.
• Robert R Weber, MD
• Wholistic Counseling and Coaching Services (Wholistic Counseling and Coaching)
• Mark Robert Wilcox, DPT

• Clinical Psychologist in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.