Individual
JACKIE SUE NIEMAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIC PSYCHOLOGIST
Contact information
Practice address
6381 OSGOOD AVE N STE 8, STILLWATER, MN 55082-6182
(651) 275-9680
(651) 430-9296
Mailing address
6381 OSGOOD AVE N STE 8, STILLWATER, MN 55082-6182
(651) 275-9680
(651) 430-9296
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3518
MN
103TB0200X
Cognitive & Behavioral Psychologist
LP3518
MN
103TC1900X
Counseling Psychologist
LP3518
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP3518
MN
103TF0000X
Family Psychologist
LP3518
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154015700
—
MN
01
—
56B45NI
BLUE CROSS BLUE SHIELD MN
MN
01
—
6236625
UNITED BEHAVIORAL HEALTH
MN
Enumeration date
08/09/2005
Last updated
02/10/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us