Active NPI
Lauren B Fogel Mersy, PSYD
- Clinical Psychologist
- St Louis Park, MN
National Provider Identifier
1932480100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5752
- Practice address
- 6600 Excelsior Blvd
St Louis Park, MN 55426-4744 - Phone
- (952) 993-7000
- NPI assigned
- Sep 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP5752 | MN | Primary |
Addresses
Primary practice location
6600 Excelsior Blvd
St Louis Park, MN 55426-4744
Mailing address
825 Nicollet Mall
Suite 300
Minneapolis, MN 55402-2606
Phone (612) 333-8883
Other names 1
- Lauren B Fogel
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 4, 2024 through Nov 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1932480100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 NICOLLET MALL",
"address_2": "SUITE 300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554022606",
"telephone_number": "612-333-8883",
"fax_number": "612-317-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264744",
"telephone_number": "952-993-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGEL MERSY",
"first_name": "LAUREN",
"middle_name": "B",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-01",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "FOGEL",
"middle_name": "B",
"code": "1",
"type": "Former Name"
}
]
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.