Individual provider Active NPI

Kerri Brigette Shear, M.A., LICENSED PSYCH

  • Counseling Psychologist
  • Minnetonka, MN
National Provider Identifier
1619100138
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP3383 Issued in MN
Practice address
13911 Ridgedale Dr Ste 404C
Minnetonka, MN 55305
Phone
(612) 598-0362
Fax
(952) 674-4680
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X LP3383 MN
Psychologist 103T00000X LP3383 MN
Counseling Psychologist 103TC1900X LP3383 MN Primary

Addresses

Primary practice location

13911 Ridgedale Dr Ste 404C
Minnetonka, MN 55305

Mailing address

13911 Ridgedale Dr Ste 404C
Minnetonka, MN 55305
Phone (612) 598-0362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 18, 2025 through Feb 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3383MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1619100138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR STE 404C",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "612-598-0362",
            "fax_number": "952-674-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR STE 404C",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "612-598-0362",
            "fax_number": "952-674-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAR",
        "first_name": "KERRI",
        "middle_name": "BRIGETTE",
        "credential": "M.A., LICENSED PSYCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP3383",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3383",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP3383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.