Individual provider Active NPI

Milena Yishak

  • School Psychologist
  • Fridley, MN
National Provider Identifier
1891603403
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
1052015 Issued in MN
Practice address
615 Mississippi St NE
Fridley, MN 55432-4423
Phone
(763) 502-5200
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 1052015 MN Primary

Addresses

Primary practice location

615 Mississippi St NE
Fridley, MN 55432-4423

Mailing address

575 Devine Dr
New Brighton, MN 55112-2314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1891603403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 DEVINE DR",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MISSISSIPPI ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324423",
            "telephone_number": "763-502-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YISHAK",
        "first_name": "MILENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "1052015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.