Rita Sandidge, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6746 Issued in MN

Practice address

1310 Highway 96 E Ste 200
White Bear Lake, MN 55110-3619

Phone

(651) 233-1382

NPI assigned

Dec 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Natalis Counseling and Psychology Solutions, P.a.

  • Psychologist
  • Saint Paul, MN
  • NPI 1447369673
  Medicare reassignment NPD
• Counseling Psychologists of Woodbury, P.a.

  • Psychologist
  • Woodbury, MN
  • NPI 1659301398

  Clinical

  NPD (past)

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1720747082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E STE 200",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103619",
            "telephone_number": "651-233-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E STE 200",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103619",
            "telephone_number": "651-233-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIDGE",
        "first_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6748",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Safe and Secure Products, Inc.
• Joelle Sakkal
• Maura Roxanne Salchow, BA
• Sam'S Club Optical
• Sams West Inc
• Nasrin H Sanei, CNM
• Jeremias Santos
• Ronald Jay Sass, DC
• Emily Sather
• Sawyer Solutions LLC

• Clinical Psychologist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.