Steven Roger Wiese, L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP1426 Issued in MN

Practice address

2780 Snelling Ave N Ste 104
Roseville, MN 55113-7115

Phone

(651) 633-5290

Fax

(651) 633-5238

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Crown Imperial Press, LLC

  dba Steven R. Wiese, M.S., M.Div, Licensed Psychologist

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1821422544
  Medicare reassignment NPD Authorized official
• The Center for Christian Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roseville, MN
  • NPI 1174776561
  NPD (past) Authorized official
• Know the Truth Ministries Inc

  dba Northland Counseling Services

  • Clinical Psychologist
  • Chanhassen, MN
  • NPI 1891725883
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194941682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21211 IMPERIAL AVE N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259547",
            "telephone_number": "651-464-1121",
            "fax_number": "651-633-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SNELLING AVE N STE 104",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137115",
            "telephone_number": "651-633-5290",
            "fax_number": "651-633-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "STEVEN",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM NON PAR PROVIDER ID",
            "identifier": "04Q65WI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whole Feelings, Therapeutic Services
• Brandon Wiberg, DO
• Richard A Wiberg, DDS
• Don Edward Wiese II, M.D.
• Kristine Elizabeth Wiese, M.D.
• Mary Wightman
• Danielle Elaine Wiklund, RN
• Laura Jane Wild, DDS
• Wildbeing Counseling LLC
• Stacey Wilkins, RN

• Psychologist in Roseville, MN
• Providers in Roseville, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.