Individual provider Active NPI

Caitlin Schneider

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1235752213
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP6878 Issued in MN
Practice address
1600 University Ave W Ste 12
Saint Paul, MN 55104-3952
Phone
(651) 379-5157
NPI assigned
May 25, 2020
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP6878 MN Primary

Addresses

Primary practice location

1600 University Ave W Ste 12
Saint Paul, MN 55104-3952

Mailing address

1600 University Ave W Ste 12
Saint Paul, MN 55104-3952

Other practice location 1

4641 Fulton Dr NW
Canton, OH 44718-2384
Phone (330) 433-6075

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
I20230724002390 MN Practitioner - Clinical Psychologist 1658731591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP6878MNMDPsychologist
6878MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Apr 13, 2026 Accepting new patients

Locations

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 252-4830

2125 E Hennepin Ave
Ste 100
Minneapolis, MN 55413
Phone (612) 217-2055

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 307-5148

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1235752213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W STE 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W STE 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043952",
            "telephone_number": "651-379-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4641 Fulton Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182384",
            "country_code": "US",
            "telephone_number": "330-433-6075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-25",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.