Shereen M O'Malley, MA, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 4846 Issued in MN

Practice address

1875 Station Parkwaynw
Andover, MN 55304-1719

Phone

(763) 482-9598

NPI assigned

May 28, 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

Other identifiers 6

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

Master of Arts

State licenses

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.

• Rum River Counseling, Inc.

  • Marriage & Family Therapist
  • Andover, MN
  • NPI 1073578472
  Medicare reassignment

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1760439327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 STATION PARKWAYNW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553041719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 STATION PARKWAYNW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553041719",
            "telephone_number": "763-482-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "SHEREEN",
        "middle_name": "M",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 4846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "101760",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519252800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP18900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "990991000633",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "483P10M",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "62-02122",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Therapy and Psychological Services
• Alyssa Novak
• Barbara Ann Nyhammer, LICSW
• Allyson Hansen Nystrom, MA CCC-SLP
• Crystal Lee Kieckhoefer O'Malley, M.S.E., CCC-SLP
• Zacharia G Ogwang, FNP
• Kenyi Okucu
• Mayowa Okuneye, CNP, MSN, MBBS, RN
• Cheryl Lynne Olmsted
• Lacey E Olson, M.S., OTR/L

• Psychologist in Andover, MN
• Providers in Andover, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.