Susan Marie Sexton, MA LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP4934 Issued in MN

Practice address

1145 Grand Avenue
#201
St Paul, MN 55105

Phone

(651) 246-3372

Fax

(952) 361-1660

NPI assigned

Sep 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Susan Marie Wimmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1649420514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 FAIRVIEW AVENUE SOUTH",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55105",
            "telephone_number": "651-246-3372",
            "fax_number": "952-361-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 GRAND AVENUE",
            "address_2": "#201",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55105",
            "telephone_number": "651-246-3372",
            "fax_number": "952-361-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "MA LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP4934",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WIMMER",
            "middle_name": "MARIE",
            "credential": "M.A., L.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine A. Severson, MD
• Matthew Chase Severson, MD
• Paul Sevett, LICSW, BC-DMT
• Emily Sevig, OT
• Nathaniel Sevy-Hassan
• Phillip Seymour, PHARM.D.
• Lindsay Leigh Shackelton
• Lauren Shafer
• Tyler Daniel Shafer, MS, LAT, ATC
• Salima Shafi, MBBS

• Psychologist in St Paul, MN
• Providers in St Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.