Individual provider Active NPI

Amelia S Paquin, PHD LP

  • Psychologist
  • Hastings, MN
National Provider Identifier
1205022753
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4849 Issued in MN
Practice address
1303 S Frontage Rd
Ste 219
Hastings, MN 55033
Phone
(651) 505-3273
Fax
(855) 344-4350
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4849 MN
Psychologist 103T00000X LP4849 MN Primary

Addresses

Primary practice location

1303 S Frontage Rd
Ste 219
Hastings, MN 55033

Mailing address

1303 S Frontage Rd Ste 150
Hastings, MN 55033-2690
Phone (612) 469-1963

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
Psychology Express Inc Psychologist CurrentSince Apr 9, 2023 Accepting new patients

Locations

2121 Cliff Dr
Ste 207
Eagan, MN 55122
Phone (952) 451-8309

1303 S Frontage Rd
Ste 150
Hastings, MN 55033
Phone (651) 419-6362

7616 Currell Blvd
Ste 170
Woodbury, MN 55125

17820 Mound Rd
Ste B
Cypress, TX 77433
Phone (281) 612-8580

11211 Katy Fwy
Ste 309
Houston, TX 77079

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1205022753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 S FRONTAGE RD STE 150",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550332690",
            "telephone_number": "612-469-1963",
            "fax_number": "855-344-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S FRONTAGE RD",
            "address_2": "STE 219",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "55033",
            "telephone_number": "651-505-3273",
            "fax_number": "855-344-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "AMELIA",
        "middle_name": "S",
        "credential": "PHD LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4849",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.