Individual provider Active NPI

Sheena C O'Brien, MA LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1598897373
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5125 Issued in MN
Practice address
658 Grand Ave Ste 201
Saint Paul, MN 55105-3492
Phone
(612) 454-1656
Fax
(651) 560-3768
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP5125 MN Primary

Addresses

Primary practice location

658 Grand Ave Ste 201
Saint Paul, MN 55105-3492

Mailing address

658 Grand Ave Ste 201
Saint Paul, MN 55105-3492
Phone (612) 454-1656

Other practice location 1

4756 Banning Ave Ste 210
White Bear Lake, MN 55110-3206
Phone (612) 454-1656

Other practice location 2

790 Cleveland Ave S Ste 217
Saint Paul, MN 55116-3845
Phone (612) 454-1656

Other practice location 3

1409 Willow St Ste 100
Minneapolis, MN 55403-2249
Phone (612) 545-1656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190128001589 MN Practitioner - Psychologist Billing Independently 7012254170 Reassigns benefits to 1 organization
I20241022001246 MN Practitioner - Mental Health Counselor 7012254170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP5125MNMDPsychologist
5125MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Grander Peace Counseling LLC CurrentSince Dec 17, 2018 Accepting new patients

Locations

1409 Willow St
Ste 100
Minneapolis, MN 55403
Phone (612) 454-1656

790 Cleveland Ave S
Ste 217
Saint Paul, MN 55116
Phone (612) 454-1656

658 Grand Ave
Ste 201
Saint Paul, MN 55105
Phone (612) 454-1656

4756 Banning Ave
Ste 210
White Bear Lake, MN 55110
Phone (612) 454-1656

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1598897373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 GRAND AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053492",
            "telephone_number": "612-454-1656",
            "fax_number": "651-560-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 GRAND AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053492",
            "telephone_number": "612-454-1656",
            "fax_number": "651-560-3768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4756 Banning Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103206",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Cleveland Ave S Ste 217",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551163845",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1409 Willow St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554032249",
            "country_code": "US",
            "telephone_number": "612-545-1656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SHEENA",
        "middle_name": "C",
        "credential": "MA LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.