Individual provider Active NPI

Nicholas Beller, PSY.D., LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1871308874
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP7156 Issued in MN
Practice address
758 Grand Ave Ste 200
Saint Paul, MN 55105-3382
Phone
(612) 800-9000
NPI assigned
Feb 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP7156 MN Primary

Addresses

Primary practice location

758 Grand Ave Ste 200
Saint Paul, MN 55105-3382

Mailing address

1295 Northland Dr Ste 270
Mendota Heights, MN 55120-1373

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

LicenseStateTypeSpecialty
LP7156MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crestpoint Wellness, LLC CurrentSince Feb 9, 2025 Accepting new patients

Locations

1295 Northland Dr
Ste 270
Mendota Heights, MN 55120
Phone (612) 900-7021

758 Grand Ave
Ste 200
Saint Paul, MN 55105
Phone (612) 800-9000

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": "1738972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1871308874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 NORTHLAND DR STE 270",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 GRAND AVE STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053382",
            "telephone_number": "612-800-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLER",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-08",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP7156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.