Individual provider Active NPI

Morgen Joray Juel, PH.D., LP

  • Clinical Psychologist
  • Baxter, MN
National Provider Identifier
1467855155
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP5716 Issued in MN
Practice address
13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone
(218) 829-9307
NPI assigned
Oct 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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 LP5716 MN Primary

Addresses

Primary practice location

13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201

Mailing address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 628-9566

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
I20141104000274 MN Practitioner - Clinical Psychologist 5991927121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone (218) 829-9307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP5716MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jan 17, 2014 Accepting new patients

Locations

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

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": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1467855155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 FALCON DR",
            "address_2": "SUITE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201",
            "telephone_number": "218-829-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUEL",
        "first_name": "MORGEN",
        "middle_name": "JORAY",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.