Joann Frances Vitelli, LP
Individual provider Active NPI Clinical Psychologist · Nashwauk, MN
NPI 1881978559 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1881978559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- LP5897 (MN)
- Practice address
- 430 E Pearson Ave
Nashwauk, MN 55769-1146 - Phone
- (218) 301-1010
- Fax
- (218) 214-9889
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northern Perspectives Psychological Services
Practice addresses (Care Compare)
430 E Pearson Ave
Nashwauk, MN 55769-1146
Phone 2183011010101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150818003054 | MN | Practitioner - Clinical Psychologist | 1759696941 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5897 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Perspectives Psychological Services | Current |
Accepting new patients | |
| Range Mental Health Center Inc | Past |
Accepting new patients |
Locations
15 NE 5th St
Grand Rapids, MN 55744
Phone (218) 259-7792
430 E Pearson Ave
Nashwauk, MN 55769
Phone (218) 301-1010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP5897 | MN | Yes |
Addresses
Primary practice location
430 E Pearson Ave
Nashwauk, MN 55769-1146
Mailing address
430 E Pearson Ave
Nashwauk, MN 55769-1146
Phone (218) 301-1010
Other providers in Nashwauk, MN
- Nashwauk Chiropractic PC
- Northern Perspectives Psychological Services
- Radtke Physical Therapy Limited Partnership
- Charity Jean Specht
- Up North Dental
- Tabitha Yuhala
All providers in Nashwauk, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.