Britt Nicole Shackelford Wessel, PSYD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP5297 Issued in MN

Practice address

3503 High Point Drive N
BLDG 3, Suite 230
Oakdale, MN 55128-6158

Phone

(612) 787-7050

Fax

(612) 844-2784

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Shackelford Professional name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lumen Psychological Services, LLC

  • Community/Behavioral Health Agency
  • Oakdale, MN
  • NPI 1457628877
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1871805614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 HIGH POINT DRIVE N",
            "address_2": "BLDG 3, SUITE 230",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286158",
            "telephone_number": "612-787-7050",
            "fax_number": "612-844-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 HIGH POINT DRIVE N",
            "address_2": "BLDG 3, SUITE 230",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286158",
            "telephone_number": "612-787-7050",
            "fax_number": "612-844-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSEL",
        "first_name": "BRITT",
        "middle_name": "NICOLE SHACKELFORD",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301108000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SHACKELFORD",
            "credential": "PSYD, LP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Debra Kay Weess, MA, LP
• Hannah Joy Weise
• Weiss & Associates
• Debra Rene Weiss, LAC., RN
• Wellspring Chiropractic
• Kristina White, O.D.
• Julie A. Whitford, LPCC
• Katherine Marie Wickstrom, CNP
• Benjamin Widbin
• Nicholaus E Widing, LADC

• Psychologist in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.