Individual provider Active NPI

Andrea Szporn, LP, PHD

  • Clinical Psychologist
  • Denver, CO
National Provider Identifier
1922023779
Registry record updated Apr 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP 4402 Issued in MN
Practice address
1600 Fillmore St Apt 207
Denver, CO 80206-1578
Phone
(612) 240-5174
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0004880 CO
Clinical Psychologist 103TC0700X LP 4402 MN Primary

Addresses

Primary practice location

1600 Fillmore St Apt 207
Denver, CO 80206-1578

Mailing address

1600 Fillmore St Apt 207
Denver, CO 80206-1578
Phone (612) 240-5174

Other practice location 1

914 S 8th St
S100
Minneapolis, MN 55404-1210
Phone (612) 347-8714

Other practice location 2

4601 Excelsior Blvd Ste 507A
St Louis Park, MN 55416-4977
Phone (612) 240-5174

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY.0004880COMDClinical Psychologist
LP 4402MNMDClinical Psychologist
4402MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Strategies for Meaningful Living, PC Clinical PastSince Aug 11, 2019 Accepting new patients

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556323200000",
    "number": "1922023779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 FILLMORE ST APT 207",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802061578",
            "telephone_number": "612-240-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 FILLMORE ST APT 207",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802061578",
            "telephone_number": "612-240-5174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "914 S 8th St",
            "address_2": "S100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041210",
            "country_code": "US",
            "telephone_number": "612-347-8714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4601 Excelsior Blvd Ste 507A",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554164977",
            "country_code": "US",
            "telephone_number": "612-240-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SZPORN",
        "first_name": "ANDREA",
        "credential": "LP, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004880",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2019; 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.