Individual provider Active NPI

Sandra Ruth Streitman, PHD, LP

  • Clinical Psychologist
  • Golden Valley, MN
National Provider Identifier
1508988981
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP0666 Issued in MN
Practice address
1405 Lilac Dr N Ste 115
Golden Valley, MN 55422-4528
Phone
(952) 457-3795
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP0666 MN Primary
School Psychologist 103TS0200X 311850 MN

Addresses

Primary practice location

1405 Lilac Dr N Ste 115
Golden Valley, MN 55422-4528

Mailing address

9031 W 34TH St
St Louis Park, MN 55426-3703
Phone (952) 457-3795

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
I20130807001057 MN Practitioner - Clinical Psychologist 8921240771

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4240 Park Glen Rd
St Louis Park, MN 55416-5427

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP0666MNMDClinical Psychologist
311850MNMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinic of Psychology Inc CurrentSince Dec 11, 2018 Accepting new patients
Sandra Streitman PLLC PastSince Jun 17, 2013 Accepting new patients

Locations

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

Organizations & group practices 2

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1508988981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 W 34TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263703",
            "telephone_number": "952-457-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 115",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224528",
            "telephone_number": "952-457-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREITMAN",
        "first_name": "SANDRA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP0666",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "311850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.