Individual provider Active NPI

Maja Palmquist

  • Clinical Child & Adolescent Psychologist
  • Saint Paul, MN
National Provider Identifier
1235711896
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
347 Smith Ave N Ste 301
Saint Paul, MN 55102-3355
Phone
(651) 220-6142
Fax
(651) 220-6707
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

347 Smith Ave N Ste 301
Saint Paul, MN 55102-3355

Mailing address

347 Smith Ave N Ste 301
Saint Paul, MN 55102-3355
Phone (651) 220-6142

Other practice location 1

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-4917

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260609001504 MN Practitioner - Clinical Psychologist 1850862053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5901 Lincolin Dr
Edina, MN 55436-1611

5901 Lincoln Drive
Edina, MN 55436-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1235711896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 SMITH AVE N STE 301",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023355",
            "telephone_number": "651-220-6142",
            "fax_number": "651-220-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 SMITH AVE N STE 301",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023355",
            "telephone_number": "651-220-6142",
            "fax_number": "651-220-6707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-4917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMQUIST",
        "first_name": "MAJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.