Individual provider Active NPI

Laura Stephan, PSYD, LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1831566991
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
475 Cleveland Ave N Ste 311
Saint Paul, MN 55104-5053
Phone
(651) 728-4500
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

475 Cleveland Ave N Ste 311
Saint Paul, MN 55104-5053

Mailing address

475 Cleveland Ave N Ste 311
Saint Paul, MN 55104-5053
Phone (651) 728-4500

Other practice location 1

900 Long Lake Rd
Suite 160
New Brighton, MN 55112-6428
Phone (651) 424-4794

Other names 1

  • Laura Sturm Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 21, 2023 through Aug 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott M Yarosh, LLC CurrentSince Feb 16, 2017 Accepting new patients
Health and Wellness Collaborative CurrentSince Sep 21, 2021 Accepting new patients

Locations

11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828

900 Long Lake Rd
Ste 160
Saint Paul, MN 55112
Phone (612) 706-9630

Organizations & group practices 2

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1831566991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLEVELAND AVE N STE 311",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045053",
            "telephone_number": "651-728-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CLEVELAND AVE N STE 311",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045053",
            "telephone_number": "651-728-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Long Lake Rd",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "551126428",
            "country_code": "US",
            "telephone_number": "651-424-4794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "LAURA",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "STURM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.