Active NPI
Paige Renee Nelson-Ansley, PSYD, LP
- Clinical Psychologist
- Plymouth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP6300
- Practice address
- 2600 Fernbrook LN N Ste 138
Plymouth, MN 55447-4752 - Phone
- (952) 544-0349
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP6300 | MN | Primary |
Addresses
Primary practice location
2600 Fernbrook LN N Ste 138
Plymouth, MN 55447-4752
Mailing address
1301 Highway 7 Apt 106
Hopkins, MN 55305-4732
Phone (952) 465-6170
Other practice location 1
14000 Northdale Blvd
Rogers, MN 55374-4662
Phone (763) 428-2478
Other practice location 2
11900 Wayzata Blvd Ste 232
Minnetonka, MN 55305-2059
Phone (952) 545-3300
Other practice location 3
40 Pearl St
Lancaster, PA 17603-3231
Phone (717) 397-8081
Other practice location 4
2600 Fernbrook Ln N Ste 134
Plymouth, MN 55447-4752
Phone (952) 544-0349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6300 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania Counseling Services Inc. | Past | Accepting new patients | |
| Autism Matters, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Plymouth, MN
- NPI 1649469289
-
- Counselor
- Lebanon, PA
- NPI 1669474979
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539820800000",
"number": "1750741641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 HIGHWAY 7 APT 106",
"city": "HOPKINS",
"state": "MN",
"postal_code": "553054732",
"telephone_number": "952-465-6170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 FERNBROOK LN N STE 138",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474752",
"telephone_number": "952-544-0349"
}
],
"practiceLocations": [
{
"address_1": "14000 Northdale Blvd",
"address_purpose": "LOCATION",
"city": "Rogers",
"state": "MN",
"postal_code": "553744662",
"country_code": "US",
"telephone_number": "763-428-2478",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11900 Wayzata Blvd Ste 232",
"address_purpose": "LOCATION",
"city": "Minnetonka",
"state": "MN",
"postal_code": "553052059",
"country_code": "US",
"telephone_number": "952-545-3300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Pearl St",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "PA",
"postal_code": "176033231",
"country_code": "US",
"telephone_number": "717-397-8081",
"fax_number": "717-397-8414",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2600 Fernbrook Ln N Ste 134",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "MN",
"postal_code": "554474752",
"country_code": "US",
"telephone_number": "952-544-0349",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON-ANSLEY",
"first_name": "PAIGE",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-04",
"last_updated": "2018-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP6300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.