Evan Stanforth, PH.D., LP
NPI 1245716703ActiveIndividual· Psychologist, Counseling· Woodbury, MN
Psychologist, Counseling (PH.D., LP) with Nystrom and Associates Ltd, practicing in Woodbury, Minnesota. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1245716703 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D., LP |
| Sole proprietor | No |
| NPI issued | Jul 17, 2018 |
| Last updated in NPPES | Apr 30, 2021 |
| Certified by provider | Apr 30, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Counseling Primary | 103TC1900X | LP6669 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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 | 2019 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Nystrom and Associates LtdBaxter, MN · 590 clinicians
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