Individual provider Active NPI

Nancy J. Arikian, PHD, LP

  • Counseling Psychologist
  • Minneapolis, MN
National Provider Identifier
1366441685
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP4396 Issued in MN
Practice address
1409 Willow St Ste 416
Minneapolis, MN 55403-2269
Phone
(612) 353-5414
Fax
(612) 353-5415
NPI assigned
Jul 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 4396 MN
Counseling Psychologist 103TC1900X LP4396 MN Primary

Addresses

Primary practice location

1409 Willow St Ste 416
Minneapolis, MN 55403-2269

Mailing address

100 S. 1St St.
#583294
Minneapolis, MN 55458-3829
Phone (612) 353-5414

Other identifiers 1

IdentifierTypeStateIssuer
088488000MedicaidMN

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
I20050103000638 MN Practitioner - Clinical Psychologist 0648238980 Practice locations: Minneapolis, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2114 22ND Ave S
Minneapolis, MN 55404-3127
Phone (612) 353-5414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP4396MNMDCounseling Psychologist
4396MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1366441685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S. 1ST ST.",
            "address_2": "#583294",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554583829",
            "telephone_number": "612-353-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST STE 416",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032269",
            "telephone_number": "612-353-5414",
            "fax_number": "612-353-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIKIAN",
        "first_name": "NANCY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "4396",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP4396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088488000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.