Individual provider Active NPI

Megan Robb, PSY.D

  • Counseling Psychologist
  • Forest Lake, MN
National Provider Identifier
1457999500
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP6491 Issued in MN
Practice address
555 W Broadway Ave Ste 2And3
Forest Lake, MN 55025-1175
Phone
(651) 251-5231
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP6491 MN Primary

Addresses

Primary practice location

555 W Broadway Ave Ste 2And3
Forest Lake, MN 55025-1175

Mailing address

555 W Broadway Ave Ste 2And3
Forest Lake, MN 55025-1175

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
I20200211000088 MN Practitioner - Clinical Psychologist 3678909603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP6491MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Canvas Health, Inc. CurrentSince Dec 22, 2019 Accepting new patients

Locations

7066 Stillwater Blvd N
Saint Paul, MN 55128

375 Orleans St E
Stillwater, MN 55082
Phone (651) 430-2720

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1457999500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BROADWAY AVE STE 2AND3",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W BROADWAY AVE STE 2AND3",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251175",
            "telephone_number": "651-251-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBB",
        "first_name": "MEGAN",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP6491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

Verify at the official NPI Registry.