Lisa Wilke, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6237 Issued in MN

Practice address

11269 Jefferson Hwy N
Champlin, MN 55316-3123

Phone

(763) 236-0600

Fax

(763) 236-0790

NPI assigned

Dec 29, 2016

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

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwilke270047@excellian.direct.allina.com

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.

• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Center for Mental Health and Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Blaine, MN
  • NPI 1457868820
  NPD Authorized official
• Allina Health System

  dba Neurosurgical Associates

  • Neurological Surgery Physician
  • Minneapolis, MN
  • NPI 1730532631
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1760927784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554800206",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11269 JEFFERSON HWY N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163123",
            "telephone_number": "763-236-0600",
            "fax_number": "763-236-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Joy Wevers, M.A.
• Whitemountain LLC
• Whitemountain LLC
• Katherine Widestrom
• Wildflower Speech
• Michelle Rose Wilkening, MD
• Mary M Wilson, MD
• Maita Yang, LICSW
• Jan Elaine Youngblood, APRN, FNP-C
• Hamza Yusuf

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.