Individual provider Active NPI

Brenda Schaeffer, MALP

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1689057705
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP0846 Issued in MN
Practice address
4525 Park Commons Dr
401
Minneapolis, MN 55416-5173
Phone
(952) 944-4046
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP0846 MN Primary

Addresses

Primary practice location

4525 Park Commons Dr
401
Minneapolis, MN 55416-5173

Mailing address

4525 Park Commons Dr
401
Minneapolis, MN 55416-5173
Phone (952) 944-4046

Other identifiers 1

IdentifierTypeStateIssuer
LP 0486OtherMIMINNESOTA LICENSED PSYCHOLOGIST

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP0846MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1689057705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 PARK COMMONS DR",
            "address_2": "401",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165173",
            "telephone_number": "952-944-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 PARK COMMONS DR",
            "address_2": "401",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165173",
            "telephone_number": "952-944-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "BRENDA",
        "credential": "MALP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSED PSYCHOLOGIST",
            "identifier": "LP 0486",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.