NPIMap

Organization Active NPI

Maplewood Psychology P.a.

  • Clinical Psychologist
  • Maplewood, MN
National Provider Identifier
1386716983
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MAPLEWOOD PSYCHOLOGY P.A.
Practice address
2399 Ariel St N Ste D
Maplewood, MN 55109-2203
Phone
(651) 770-1311
Fax
(651) 770-1879
NPI assigned
Nov 15, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Dr. Sandra M Wick, PHD, LPNPI 1285784405
Title
Director
Phone
(651) 770-1311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

2399 Ariel St N Ste D
Maplewood, MN 55109-2203

Mailing address

2399 Ariel St N Ste D
Maplewood, MN 55109-2203
Phone (651) 770-1311

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1386716983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 ARIEL ST N STE D",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092203",
            "telephone_number": "651-770-1311",
            "fax_number": "651-770-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 ARIEL ST N STE D",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092203",
            "telephone_number": "651-770-1311",
            "fax_number": "651-770-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PSYCHOLOGY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "WICK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-770-1311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.