Active NPI
Michael Lawrence Richardson, M.S.ED, L.P.
- Psychologist
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP 0196
- Practice address
- 2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1052 - Phone
- (651) 645-3115
- Fax
- (651) 645-2752
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP 0196 | MN | Primary |
Addresses
Primary practice location
2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1052
Mailing address
2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1052
Phone (651) 645-3115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9033505000 | Medicaid | MN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of Wisconsin School of Medicine, 1981
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5995 Oren Ave N
Suite 203
Oak Park Heights, MN 55082-6379
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 0196 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vantage Mental Health | Current | Accepting new patients | |
| St. Croix Psychiatric, LLC | Current | Accepting new patients | |
| Nystrom & Associates, LTD | Current | Accepting new patients | |
| Psych Recovery Inc | Psychologist | Past | Accepting new patients |
| Psychiatric Recovery PA | Past | Accepting new patients |
Locations
2125 E Hennepin Ave
Ste 100
Minneapolis, MN 55413
Phone (612) 217-2055
9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800
1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080
5995 Oren Ave N
Ste 203
Stillwater, MN 55082
Phone (651) 217-1480
659 Bielenberg Dr
Woodbury, MN 55125
Phone (651) 259-9700
Organizations & group practices 5
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.
-
dba PrairieCare Medical Group
- Psychiatry Physician
- Woodbury, MN
- NPI 1881849586
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Oak Park Heights, MN
- NPI 1538990288
-
dba Sagent Behavioral Health
- Clinical Social Worker
- New Brighton, MN
- NPI 1396750188
-
- Adolescent and Children Mental Health Clinic/Center
- Saint Paul, MN
- NPI 1891713681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447312251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE W",
"address_2": "SUITE 229N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141052",
"telephone_number": "651-645-3115",
"fax_number": "651-645-2752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE W",
"address_2": "SUITE 229N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141052",
"telephone_number": "651-645-3115",
"fax_number": "651-645-2752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "MICHAEL",
"middle_name": "LAWRENCE",
"credential": "M.S.ED, L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP 0196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9033505000",
"state": "MN"
}
],
"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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.