Midwest Minds Assessment and Therapy, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MIDWEST MINDS ASSESSMENT AND THERAPY, PLLC

Doing business as

Midwest Minds

Practice address

1937 Woodlane Dr Ste 101
Woodbury, MN 55125-4043

Phone

(651) 764-8480

NPI assigned

Jun 4, 2024

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Nippooldt-Baca, PSYD, LP, ABPP

Title

Neuropsychologist/Owner

Phone

(651) 283-0639

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Midwest Minds Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Joan Nippoldt-Baca, PSYD, LP, ABPP

  • Clinical Neuropsychologist
  • Woodbury, MN
  • NPI 1720314909
  NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1376384370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 WOODLANE DR STE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254043",
            "telephone_number": "651-764-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 WOODLANE DR STE 101",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254043",
            "telephone_number": "651-764-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MINDS ASSESSMENT AND THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "NIPPOOLDT-BACA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "NEUROPSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "651-283-0639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP, ABPP"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356698294",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568606077",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467712182",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Minds",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Midwest Minds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlen Midthune
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• Midwest Surgery Center
• Midwest Surgery Center, LLC (Midwest Surgery Center- Woodbury)
• Alexa Jesse Miesbauer, PT, DPT
• Migdal Psychological Services, LLC
• Lori Elmer Migdal, PH.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.