John Richard Anderson, PH.D.
Individual provider Active NPI Clinical Psychologist · Anoka, MN
NPI 1720973290 · NPPES record last updated Jun 12, 2025
Key facts
- NPI
- 1720973290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- LP6734 (MN)
- Practice address
- 3301 7TH Ave
Anoka, MN 55303-4516 - Phone
- (651) 431-5337
- NPI assigned
- Jun 12, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6734 | MN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP6734 | MN | Yes |
Addresses
Primary practice location
3301 7TH Ave
Anoka, MN 55303-4516
Mailing address
3301 7TH Ave
Anoka, MN 55303-4516
Other providers in Anoka, MN
- America'S Best Hearing LLC
- Americas Hearing Group LLC
- Gabrielle Julia Andersen
- Abby Anderson
- Dwight Anthony Anderson
- Kathryn Lynne Anderson
- Lilly Jean Anderson
- Lydia Anderson
- Davika Serene Annis
- Anoka Cares Transportation LLC
All providers in Anoka, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.