Individual provider Active NPI

Nora Grace Halverson, PHD, LP

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1528744588
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP7095 Issued in MN
Practice address
1509 27TH Ave NE
Minneapolis, MN 55418-3034
Phone
(612) 389-9266
Fax
(612) 453-0725
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X LP7095 MN Primary

Addresses

Primary practice location

1509 27TH Ave NE
Minneapolis, MN 55418-3034

Mailing address

1509 27TH Ave NE
Minneapolis, MN 55418-3034
Phone (612) 389-9266

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
I20250731001682 MN Practitioner - Clinical Psychologist 3779091921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1509 27TH Ave NE
Minneapolis, MN 55418-3034
Phone (612) 465-9734

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP7095MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Hope Psychological Services LLC CurrentSince Jun 2, 2025 Accepting new patients

Locations

1509 27th Ave NE
Minneapolis, MN 55418
Phone (612) 465-9734

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1528744588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 27TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183034",
            "telephone_number": "612-389-9266",
            "fax_number": "612-453-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 27TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183034",
            "telephone_number": "612-389-9266",
            "fax_number": "612-453-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "NORA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP7095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.