Active NPI
Sarah Jo Pavek, M.A.,L.P.
- Psychologist
- Inver Grove Heights, MN
National Provider Identifier
1770612913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP3102
- Practice address
- 5802 Blackshire Path Ste 221
Inver Grove Heights, MN 55076-1618 - Phone
- (651) 470-3098
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | LP3102 | MN | |
| Psychologist | 103T00000X | LP3102 | MN | Primary |
Addresses
Primary practice location
5802 Blackshire Path Ste 221
Inver Grove Heights, MN 55076-1618
Mailing address
4587 Blaylock Cir
Inver Grove Heights, MN 55076-1162
Phone (651) 470-3098
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3102 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1770612913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4587 BLAYLOCK CIR",
"city": "INVER GROVE HEIGHTS",
"state": "MN",
"postal_code": "550761162",
"telephone_number": "651-470-3098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5802 BLACKSHIRE PATH STE 221",
"city": "INVER GROVE HEIGHTS",
"state": "MN",
"postal_code": "550761618",
"telephone_number": "651-470-3098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVEK",
"first_name": "SARAH",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "M.A.,L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "LP3102",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inver Grove Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.