Active NPI
Olivia Marie Weber
- Clinical Psychologist
- Saint Cloud, MN
National Provider Identifier
1790415768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP7011
- Practice address
- 4801 Veterans Dr
Saint Cloud, MN 56303-2015 - Phone
- (320) 252-1670
- NPI assigned
- Jun 13, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | |||
| Clinical Psychologist | 103TC0700X | LP7011 | MN | Primary |
Addresses
Primary practice location
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Mailing address
62 Vincent St S
Pierz, MN 56364-1513
Phone (320) 310-3265
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP7011 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1790415768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 VINCENT ST S",
"city": "PIERZ",
"state": "MN",
"postal_code": "563641513",
"telephone_number": "320-310-3265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 VETERANS DR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032015",
"telephone_number": "320-252-1670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "OLIVIA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-13",
"last_updated": "2025-02-26",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP7011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.