Individual provider Active NPI

Karen F Heegaard, M.A. L.P.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1386770998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3419 Issued in MN
Practice address
1133 Grand Ave
Saint Paul, MN 55105-2629
Phone
(651) 641-0177
Fax
(641) 641-8635
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3419 MN Primary

Addresses

Primary practice location

1133 Grand Ave
Saint Paul, MN 55105-2629

Mailing address

3912 Pleasant Ave
Minneapolis, MN 55409-1529
Phone (612) 810-7349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3419MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386770998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 PLEASANT AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091529",
            "telephone_number": "612-810-7349",
            "fax_number": "612-824-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-641-0177",
            "fax_number": "641-641-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEGAARD",
        "first_name": "KAREN",
        "middle_name": "F",
        "credential": "M.A. L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.