Patricia J. Mactaggert, M.A.,L.P.
Individual provider Active NPI Psychologist · Mound, MN
NPI 1710016043 · NPPES record last updated Aug 22, 2025
Key facts
- NPI
- 1710016043
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- LP2278 (MN)
- Practice address
- 2301 Lost Lake CT
Mound, MN 55364-4512 - Phone
- (612) 803-2533
- NPI assigned
- Mar 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
Mound, MN 55364
Phone (612) 803-2533
7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1957
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251001001807 | MN | Practitioner - Mental Health Counselor | 4789180530 | Practice locations: Mound, MN |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2278 | MN | Yes |
Addresses
Primary practice location
2301 Lost Lake CT
Mound, MN 55364-4512
Mailing address
2301 Lost Lake CT
Mound, MN 55364-4512
Phone (612) 803-2533
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68413ST | Other | MN | BLUECROSSBLUESHIELD PROVI |
Other names
- Patricia J Sternau
Other providers in Mound, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.