Individual provider Active NPI

Lisa Charleen Cowley, PSYD, LP

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1366479347
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4682 Issued in MN
Practice address
Ufp Bethesda Clinic
580 Rice Street
Saint Paul, MN 55103
Phone
(651) 227-6551
Fax
(651) 665-0684
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP4682 MN
Clinical Psychologist 103TC0700X LP4682 MN Primary

Addresses

Primary practice location

Ufp Bethesda Clinic
580 Rice Street
Saint Paul, MN 55103

Mailing address

Ufp Bethesda Clinic
580 Rice Street
Saint Paul, MN 55103
Phone (651) 227-6551

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
I20060727000204 MN Practitioner - Clinical Psychologist 6507879103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Recovery IncGroup PAC ID 3779633912, 22 clinicians

Practice addresses (Care Compare)

2550 University Ave W
Suite 229 N
St. Paul, MN 55114-1052

2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4682MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Recovery PA Past Accepting new patients

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1366479347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UFP BETHESDA CLINIC",
            "address_2": "580 RICE STREET",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55103",
            "telephone_number": "651-227-6551",
            "fax_number": "651-665-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UFP BETHESDA CLINIC",
            "address_2": "580 RICE STREET",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55103",
            "telephone_number": "651-227-6551",
            "fax_number": "651-665-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWLEY",
        "first_name": "LISA",
        "middle_name": "CHARLEEN",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4682",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.