Individual provider Active NPI

Shelley A. Leutschaft, PHD, LP

  • Psychologist
  • Owatonna, MN
National Provider Identifier
1427430735
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4834 Issued in MN
Practice address
1560 Deer Trail LN NE
Owatonna, MN 55060-2096
Phone
(507) 363-2136
Fax
(972) 323-8640
NPI assigned
Jun 23, 2015
Reactivated
Oct 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP4834 MN Primary

Addresses

Primary practice location

1560 Deer Trail LN NE
Owatonna, MN 55060-2096

Mailing address

PO Box 306
Owatonna, MN 55060-0306
Phone (507) 363-2136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000648 MN Practitioner - Clinical Psychologist 4981917002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Modern MojoGroup PAC ID 1456621457, 6 clinicians

Practice addresses (Care Compare)

28 NW 4TH St
Suite a
Grand Rapids, MN 55744-2714
Phone (218) 999-7750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP4834MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Mojo CurrentSince Oct 10, 2019 Accepting new patients
Lovestrong Integrative Services, LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

28 NW 4th St
Ste A
Grand Rapids, MN 55744
Phone (218) 326-1274

Organizations & group practices 2

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1427430735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550600306",
            "telephone_number": "507-363-2136",
            "fax_number": "972-323-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 DEER TRAIL LN NE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550602096",
            "telephone_number": "507-363-2136",
            "fax_number": "972-323-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUTSCHAFT",
        "first_name": "SHELLEY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "deactivation_date": "2017-09-22",
        "reactivation_date": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.