Lisa Marie Anderson, PHD
NPI 1114504123ActiveIndividual· Psychologist, Clinical· Maple Grove, MN
Psychologist, Clinical (PHD) in Maple Grove, Minnesota, licensed in MN, with an NPI issued in March 2021. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1114504123 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Mar 25, 2021 |
| Last updated in NPPES | Oct 30, 2026 |
| Certified by provider | Oct 30, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP6534 | 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) |
|---|
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