Individual provider Active NPI

Katherine Sarah Fabrizio, PH.D.

  • Clinical Psychologist
  • Edina, MN
National Provider Identifier
1609895531
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5551 Issued in MN
Practice address
5200 Willson Rd Ste 150
Edina, MN 55424-1300
Phone
(612) 416-3311
Fax
(612) 416-3311
NPI assigned
Jul 19, 2006
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5551 MN Primary

Addresses

Primary practice location

5200 Willson Rd Ste 150
Edina, MN 55424-1300

Mailing address

5200 Willson Rd Ste 150
Edina, MN 55424-1300
Phone (612) 416-3311

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
I20130124000147 MN Practitioner - Clinical Psychologist 6406009588 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5200 Willson Rd
Suite 150
Edina, MN 55424-1300
Phone (612) 416-3311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5551MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Sep 15, 2014 Accepting new patients
Danielle Golden, Crna, PA CurrentSince Nov 10, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fabrizio Neuropsychology PLLC Clinical CurrentSince Jan 1, 2024 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 15, 2014 Accepting new patients

Locations

5200 Willson Rd
Ste 150
Minneapolis, MN 55424
Phone (763) 270-0054

1650 Beam Ave
Ste 200
Saint Paul, MN 55109
Phone (651) 221-9051

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

3555 Willow Lake Blvd
Ste 290
Vadnais Heights, MN 55110

3640 Talmage Cir
Ste 216
Vadnais Hts, MN 55110
Phone (651) 379-4006

Organizations & group practices 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1609895531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 150",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241300",
            "telephone_number": "612-416-3311",
            "fax_number": "612-416-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 150",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241300",
            "telephone_number": "612-416-3311",
            "fax_number": "612-416-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIO",
        "first_name": "KATHERINE",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.