Tatiana Komleva, PSY.D., LP.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5990 Issued in MN

Practice address

100 Freeman Dr
Saint Peter, MN 56082-3504

Phone

(507) 985-2530

NPI assigned

Apr 1, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1386448231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FREEMAN DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560823504",
            "telephone_number": "507-985-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FREEMAN DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560823504",
            "telephone_number": "507-985-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMLEVA",
        "first_name": "TATIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "5990",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MN",
            "license": "5990",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MN",
            "license": "5990",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "5990",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MN",
            "license": "5990",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kluge, MSW, LICSW
• Sable Dawn Knochenmus
• Lon T Knudson, MD
• Rachel Elizabeth Knudson, CPM, LM
• Raymond John Knutson, M.A., L.P.
• Jenny A Kortuem, MS CCC-SLP
• John Howard Krohn
• Ashley Krug, ATC
• Shannon Marie Kuball, LMFT
• Carol Jean Kuisle, LICSW

• Clinical Psychologist in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.