Individual provider Active NPI

Sarah Elizabeth Taylor, PSYD

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1396095618
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.010048 Issued in IL
Practice address
5625 21St Ave S
Minneapolis, MN 55417-2622
Phone
(703) 303-4684
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.010048 IL Primary

Addresses

Primary practice location

5625 21St Ave S
Minneapolis, MN 55417-2622

Mailing address

5625 21St Ave S
Minneapolis, MN 55417-2622
Phone (703) 303-4684

Other practice location 1

223 Addison Rd
Riverside, IL 60546-2003
Phone (703) 303-4684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 29, 2025 through Dec 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.010048ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Express Inc Past Accepting new patients

Organizations & group practices 1

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1396095618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 21ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172622",
            "telephone_number": "703-303-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 21ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172622",
            "telephone_number": "703-303-4684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Addison Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "IL",
            "postal_code": "605462003",
            "country_code": "US",
            "telephone_number": "703-303-4684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.