Active NPI
Holly McMichael Symons, PSYD; LP
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1811271026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP6529
- Practice address
- 1801 Nicollet Ave
Minneapolis, MN 55403-3791 - Phone
- (612) 596-9438
- Fax
- (382) 261-2879
- NPI assigned
- Oct 6, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP6529 | MN | Primary |
Addresses
Primary practice location
1801 Nicollet Ave
Minneapolis, MN 55403-3791
Mailing address
1801 Nicollet Ave
Minneapolis, MN 55403-3791
Phone (612) 596-9438
Other names 1
- Holly McMichael
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6529 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hennepin County | Clinical | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1811271026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 NICOLLET AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033791",
"telephone_number": "612-596-9438",
"fax_number": "612-879-3822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 NICOLLET AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033791",
"telephone_number": "612-596-9438",
"fax_number": "382-261-2879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMICHAEL SYMONS",
"first_name": "HOLLY",
"credential": "PSYD; LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-06",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP6529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HOLLY",
"last_name": "MCMICHAEL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.