Laura Smith, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5810 Issued in MN

Practice address

4050 Olson Memorial Hwy Ste 195
Golden Valley, MN 55422-5345

Phone

(763) 454-4102

NPI assigned

Oct 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Minnesota Mental Health Center

  • Mental Health Counselor
  • Saint Cloud, MN
  • NPI 1831177195
  Medicare reassignment NPD
• Central Minnesota Mental Health Center

  • Counselor
  • Saint Cloud, MN
  • NPI 1053576546
  NPD
• Central Minnesota Mental Health Center

  dba Great River ACT-St. Cloud

  • Mental Health Counselor
  • Saint Cloud, MN
  • NPI 1639384043
  NPD
• Woods Psychological Services LLC

  • Clinical Psychologist
  • Winona, MN
  • NPI 1407490444
  NPD (past)

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1558765065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 OLSON MEMORIAL HWY STE 195",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 OLSON MEMORIAL HWY STE 195",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225345",
            "telephone_number": "763-454-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Anne Slezak-Moser, MA
• Deborah Slovut
• Anna Smith, CCC-SLP
• David Taylor Smith, PH.D., LICSW
• Ernest Smith, MSW, LICSW
• Trizer Smith
• Snap Medical Supply LLC
• Soderberg Physical Therapy LLC
• Eldon Soderberg, PT
• Sandra Soderberg, PT

• Clinical Psychologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.