Active NPI
Michael John Maley, MICHAEL MALEY, PH.D.
- Clinical Psychologist
- Wayzata, MN
National Provider Identifier
1841348968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP 0030
- Practice address
- 2717 Hidden Creek LN
Wayzata, MN 55391-2559 - Phone
- (952) 542-9480
- Fax
- (952) 938-0158
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | LP 0030 | MN | Primary |
Addresses
Primary practice location
2717 Hidden Creek LN
Wayzata, MN 55391-2559
Mailing address
2717 Hidden Creek LN
Wayzata, MN 55391-2559
Phone (952) 542-9480
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61-94139 | Other | MN | MEDICA |
| 84761 | Other | MN | HEALTH PARTNERS |
| 10673 MA | Other | MN | BCBS |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 0030 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841348968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2717 HIDDEN CREEK LN",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553912559",
"telephone_number": "952-542-9480",
"fax_number": "952-938-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2717 HIDDEN CREEK LN",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553912559",
"telephone_number": "952-542-9480",
"fax_number": "952-938-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALEY",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MICHAEL MALEY, PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP 0030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "61-94139",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "84761",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "10673 MA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayzata, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.