Active NPI
Sofianyeli Colon-Requejo, PSYD, LP
- Clinical Psychologist
- Minnetonka, MN
National Provider Identifier
1962140194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP6831
- Practice address
- 601 Carlson Pkwy
Minnetonka, MN 55305-5203 - Phone
- (323) 205-7088
- NPI assigned
- May 26, 2022
- Last updated
- May 15, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP6831 | MN | Primary |
| Psychologist | 103T00000X | LP6831 | MN |
Addresses
Primary practice location
601 Carlson Pkwy
Minnetonka, MN 55305-5203
Mailing address
15578 Empress Ave N Unit 5
Hugo, MN 55038-4620
Phone (787) 988-9790
Other practice location 1
15251 Pleasant Valley Rd
Center City, MN 55012-9640
Phone (651) 213-4120
Other practice location 2
680 Stewart Ave
Saint Paul, MN 55102-4117
Phone (651) 312-3070
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6831 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1962140194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15578 EMPRESS AVE N UNIT 5",
"city": "HUGO",
"state": "MN",
"postal_code": "550384620",
"telephone_number": "787-988-9790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CARLSON PKWY",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553055203",
"telephone_number": "323-205-7088"
}
],
"practiceLocations": [
{
"address_1": "15251 Pleasant Valley Rd",
"address_purpose": "LOCATION",
"city": "Center City",
"state": "MN",
"postal_code": "550129640",
"country_code": "US",
"telephone_number": "651-213-4120",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "680 Stewart Ave",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551024117",
"country_code": "US",
"telephone_number": "651-312-3070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLON-REQUEJO",
"first_name": "SOFIANYELI",
"name_prefix": "Dr.",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP6831",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP6831",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.