Mark Allen Sander, PSYD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4445 Issued in MN

Practice address

9531 W 78TH St
Suite 135
Eden Prairie, MN 55344-3810

Phone

(612) 825-4407

Fax

(612) 825-0768

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740388198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-825-4407",
            "fax_number": "612-825-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9531 W 78TH ST",
            "address_2": "SUITE 135",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443810",
            "telephone_number": "612-825-4407",
            "fax_number": "612-825-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "4445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Emily Samuelson
• Nathaniel Saul Samuelson, DC
• Andres Roberto Sanchez, DDS
• Ingrid Sanchez, MA
• Ilyne Sandas, MALP
• Sarah L Sander
• Nikhita Sandesh
• Sartorial Physical Therapy and Wellness
• Susan M Saunders
• Maggie Marie Sazama, RDN

• Psychologist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.