Active NPI
Michael Fendt, PH.D.
- Clinical Psychologist
- Saint Paul, MN
National Provider Identifier
1598900136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP3910
- Practice address
- 360 Sherman St
Saint Paul, MN 55102-2564 - Phone
- (651) 724-9411
- NPI assigned
- Dec 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP3910 | MN | Primary |
Addresses
Primary practice location
360 Sherman St
Saint Paul, MN 55102-2564
Mailing address
PO Box 3
South Saint Paul, MN 55075-0003
Phone (651) 705-2423
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3910 | MN | MD | Clinical Psychologist |
| 3910 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1598900136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3",
"city": "SOUTH SAINT PAUL",
"state": "MN",
"postal_code": "550750003",
"telephone_number": "651-705-2423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 SHERMAN ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551022564",
"telephone_number": "651-724-9411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENDT",
"first_name": "MICHAEL",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-11",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP3910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.