Individual provider Active NPI

Jeffrey Hill, PSYD, LP

  • Clinical Psychologist
  • Richfield, MN
National Provider Identifier
1982917415
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP 5464 Issued in MN
Practice address
6425 Nicollet Ave
Richfield, MN 55423-1675
Phone
(612) 861-1675
Fax
(612) 861-3446
NPI assigned
Jul 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP 5464 MN Primary
Cognitive & Behavioral Psychologist 103TB0200X LP 5464 MN
Clinical Psychologist 103TC0700X LP5464 MN
Clinical Child & Adolescent Psychologist 103TC2200X LP 5464 MN
Family Psychologist 103TF0000X LP 5464 MN
Group Psychotherapy Psychologist 103TP2701X LP 5464 MN

Addresses

Primary practice location

6425 Nicollet Ave
Richfield, MN 55423-1675

Mailing address

6425 Nicollet Ave
Richfield, MN 55423-1675
Phone (612) 861-1675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160609000399 MN Practitioner - Clinical Psychologist 6305136011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP5464MNMDClinical Psychologist
LP 5464MNMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Youable Emotional Health Services CurrentSince Nov 25, 2024 Accepting new patients

Locations

6425 Nicollet Ave
Richfield, MN 55423
Phone (612) 861-1675

6425 Nicollet Ave
Ste 210
Richfield, MN 55423
Phone (612) 861-1675

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": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1982917415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 5464",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP 5464",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5464",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP 5464",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "LP 5464",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "LP 5464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.