Maria Mercedes Riccardi, PSY D LP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

LP5779 Issued in MN

Practice address

1406 6TH Avenue North
St Cloud Hospital
St. Cloud, MN 56303-1900

Phone

(320) 251-2700

Fax

(320) 656-7115

NPI assigned

Sep 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1780918763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCARDI",
        "first_name": "MARIA",
        "middle_name": "MERCEDES",
        "credential": "PSY D LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP5779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Revermann, L.AC.
• Sara Suzanne Revier, C.N.S.
• Beth Elaine Rhoads
• Bobbi Lynn Rhodes, RN, BSN
• Nyakuech Rith Rial
• Linnea Rice Epsky
• Steven William Rice, MD
• Anne E. Rich, CNP
• Kelly Richards, LPN
• Patrick Richardsfink

• Clinical Child & Adolescent Psychologist in St. Cloud, MN
• Providers in St. Cloud, MN by specialty
• Clinical Child & Adolescent Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.