Individual provider Active NPI

Diane Caspers, LICENSED PSYCHOLOGST

  • Psychologist
  • Mankato, MN
National Provider Identifier
1356473193
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3413 Issued in MN
Practice address
151 Saint Andrews CT Ste 710
Mankato, MN 56001-8815
Phone
(073) 867-1215
Fax
(507) 344-0690
NPI assigned
Mar 9, 2007
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3413 MN Primary

Addresses

Primary practice location

151 Saint Andrews CT Ste 710
Mankato, MN 56001-8815

Mailing address

151 Saint Andrews CT Ste 710
Mankato, MN 56001-8815
Phone (507) 386-7121

Other identifiers 1

IdentifierTypeStateIssuer
420080100MedicaidMN

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

State licenses

LicenseStateTypeSpecialty
LP3413MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Journeys Toward Healing Counseling Center LLC CurrentSince Jan 29, 2023 Accepting new patients
Lutheran Social Service of Minnesota PastSince Jan 1, 2020 Accepting new patients

Locations

151 Saint Andrews Ct
Ste 710
Mankato, MN 56001
Phone (507) 386-7121

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, 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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1356473193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SAINT ANDREWS CT STE 710",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018815",
            "telephone_number": "507-386-7121",
            "fax_number": "507-344-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SAINT ANDREWS CT STE 710",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018815",
            "telephone_number": "073-867-1215",
            "fax_number": "507-344-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASPERS",
        "first_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LICENSED PSYCHOLOGST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-07-27",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420080100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.