Individual provider Active NPI

Victoria Sybilla Hadley

  • Psychiatric/Mental Health Nurse Practitioner
  • Monticello, MN
National Provider Identifier
1255976387
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7055 Issued in MN
Practice address
305 Cedar St Ste 102
Monticello, MN 55362-8304
Phone
(763) 200-1160
Fax
(763) 645-5458
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7055 MN Primary

Addresses

Primary practice location

305 Cedar St Ste 102
Monticello, MN 55362-8304

Mailing address

305 Cedar St Ste 102
Monticello, MN 55362-8304
Phone (763) 200-1160

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200103002270 MN Practitioner - Nurse Practitioner 0345674065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

305 Cedar St
Suite 102
Monticello, MN 55362-8304
Phone (763) 559-1640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7055MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Mental Health, PLLC Psychiatric/Mental Health CurrentSince Mar 1, 2023 Accepting new patients
Plymouth Psych Group, LLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

305 Cedar St
Ste 102
Monticello, MN 55362
Phone (763) 200-1160

9655 Schmidt Lake Rd
Ste 150
Plymouth, MN 55442
Phone (763) 559-1640

Organizations & group practices 2

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1255976387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 CEDAR ST STE 102",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628304",
            "telephone_number": "763-200-1160",
            "fax_number": "763-645-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 CEDAR ST STE 102",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628304",
            "telephone_number": "763-200-1160",
            "fax_number": "763-645-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "VICTORIA",
        "middle_name": "SYBILLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "7055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.