Individual provider Active NPI

Simmie J. Parlow, PH.D.

  • Psychologist
  • Edina, MN
National Provider Identifier
1770655706
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP2888 Issued in MN
Practice address
5809 Merold Dr
Edina, MN 55436-2258
Phone
(952) 303-4163
Fax
(952) 303-4185
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP2888 MN Primary
Psychologist 103T00000X

Addresses

Primary practice location

5809 Merold Dr
Edina, MN 55436-2258

Mailing address

5809 Merold Dr
Edina, MN 55436-2258
Phone (952) 303-4163

Other identifiers 3

IdentifierTypeStateIssuer
2H186PAOtherMNBLUE CROSS
830053400MedicaidMN
61-08958OtherMNMEDICA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050422001098 MN Practitioner - Clinical Psychologist 1153369715 Practice locations: Edina, MN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP2888MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Human Development of White Bear Lake, Inc. Psychologist PastSince Jan 15, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1770655706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 MEROLD DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362258",
            "telephone_number": "952-303-4163",
            "fax_number": "952-303-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 MEROLD DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362258",
            "telephone_number": "952-303-4163",
            "fax_number": "952-303-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARLOW",
        "first_name": "SIMMIE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2888",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2H186PA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830053400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "61-08958",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.