Susan Medlicott Eckfeldt, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3045 Issued in MN

Practice address

540 Fairview Ave N
Suite 302
Saint Paul, MN 55104-1796

Phone

(651) 210-8353

Fax

(651) 952-0538

NPI assigned

Jan 13, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Susan Eckfeldt

  • Psychologist
  • Saint Paul, MN
  • NPI 1942331889
  NPD (past) Authorized official

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1154472561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 FAIRVIEW AVE N",
            "address_2": "SUITE 302",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041796",
            "telephone_number": "651-210-8353",
            "fax_number": "651-952-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FAIRVIEW AVE N",
            "address_2": "SUITE 302",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041796",
            "telephone_number": "651-210-8353",
            "fax_number": "651-952-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKFELDT",
        "first_name": "SUSAN",
        "middle_name": "MEDLICOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker M Eberwein, MD
• Ebh Capital Inc.
• Gloria Joy Eby, LPN
• Kelsey Echols, M.D.
• Rachel Novotny Ecker, D.M.D.
• Shelby Rae Eckhart
• Kaija Eckholm, PT, DPT
• Michelle Ecklund
• Erik Sethre Eckman, M.D.
• David R Eckmann, MD

• Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.