Amanda Exman, PSY.D., LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6343 Issued in MN

Practice address

11334 86TH Ave N
Maple Grove, MN 55369-4528

Phone

(763) 255-2125

NPI assigned

Jan 22, 2019

Last updated

Jan 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Exman Psychological Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arden Hills, MN
  • NPI 1922660083
  NPD (past) Authorized official

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1821562000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 253RD AVE NW",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550404203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11334 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694528",
            "telephone_number": "763-255-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXMAN",
        "first_name": "AMANDA",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bachu Mekonnen Eticha
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• Terry L Evers, APNP
• Renata R Evertz, D.C.
• Hannah Mathilde Evju
• Gina Fabiano, LAC
• Fairview Clinics (Fairview Clinics-Bass Lake)
• Fairview Clinics (Fairview Clinics-Maple Grove)
• Fairview Express Care
• Fairview Maple Grove Surgery Center, LLC

• Psychologist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.