Individual provider Active NPI

Michelle A Schmid-Egleston, MA LP

  • Psychologist
  • Golden Valley, MN
National Provider Identifier
1487681474
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3811 Issued in MN
Practice address
8401 Wayzata Blvd Ste 370
Golden Valley, MN 55426-1379
Phone
(762) 544-1006
Fax
(763) 544-1008
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3811 MN Primary

Addresses

Primary practice location

8401 Wayzata Blvd Ste 370
Golden Valley, MN 55426-1379

Mailing address

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3811MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Therapy Current Accepting new patients
Secure Base Counseling Center LLC Psychologist CurrentSince Mar 15, 2020 Accepting new patients
Hoy & Associates Inc. Past Accepting new patients

Locations

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

6607 18th Ave S
Ste 101
Richfield, MN 55423
Phone (612) 798-7373

Organizations & group practices 3

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1487681474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-301-3412",
            "fax_number": "507-301-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 WAYZATA BLVD STE 370",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261379",
            "telephone_number": "762-544-1006",
            "fax_number": "763-544-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID-EGLESTON",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.