Michelle K. Pemble-Frazey, PHD
NPI 1013116342ActiveIndividual· Psychologist, Cognitive & Behavioral· Maple Grove, MN
Psychologist, Cognitive & Behavioral (PHD) with Park Nicollet Clinic, practicing in Maple Grove, Minnesota. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1013116342 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jul 17, 2007 |
| Last updated in NPPES | Sep 13, 2023 |
| Certified by provider | Sep 13, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Cognitive & Behavioral Primary | 103TB0200X | LP4824 | MN |
| Psychologist | 103T00000X | LP4824 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MN) |
|---|
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Park Nicollet ClinicSt Louis Park, MN · 1,787 clinicians
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