Individual provider Active NPI

Wendy Jean Anderson, M.A., L.P.P.

  • Counseling Psychologist
  • Minneapolis, MN
National Provider Identifier
1275789786
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP5059 Issued in MN
Practice address
3915 Golden Valley Rd
Minneapolis, MN 55422-4249
Phone
(612) 775-2421
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP5059 MN Primary

Addresses

Primary practice location

3915 Golden Valley Rd
Minneapolis, MN 55422-4249

Mailing address

3915 Golden Valley Rd
Minneapolis, MN 55422-4249
Phone (612) 775-2421

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP5059MNMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1275789786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "612-775-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "612-775-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "WENDY",
        "middle_name": "JEAN",
        "credential": "M.A., L.P.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP5059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.