Active NPI
Melissa Kloss, PSY.D.
- Clinical Psychologist
- Prior Lake, MN
National Provider Identifier
1457736969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5913
- Practice address
- 16180 Hastings Ave SE
Prior Lake, MN 55372-9227 - Phone
- (952) 443-4600
- NPI assigned
- Jul 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MN | ||
| Clinical Psychologist | 103TC0700X | LP5913 | MN | Primary |
Addresses
Primary practice location
16180 Hastings Ave SE
Prior Lake, MN 55372-9227
Mailing address
16180 Hastings Ave SE
Prior Lake, MN 55372
Phone (952) 443-4600
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1457736969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16180 HASTINGS AVE SE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "55372",
"telephone_number": "952-443-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16180 HASTINGS AVE SE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553729227",
"telephone_number": "952-443-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOSS",
"first_name": "MELISSA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prior Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.