Individual provider Active NPI

Elizabeth Alice Sharer, MA

  • Clinical Child & Adolescent Psychologist
  • Bloomington, MN
National Provider Identifier
1720653587
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
1801 American Blvd E
Bloomington, MN 55425-1232
Phone
(651) 424-4044
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X MN Primary

Addresses

Primary practice location

1801 American Blvd E
Bloomington, MN 55425-1232

Mailing address

1801 American Blvd E
Bloomington, MN 55425-1232
Phone (651) 424-4044

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
I20250304000128 MN Practitioner - Clinical Psychologist 4789105008 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Jan 9, 2025 Accepting new patients

Locations

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1720653587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "651-424-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "651-424-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARER",
        "first_name": "ELIZABETH",
        "middle_name": "ALICE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.