Jackie Sue Niemand, LIC PSYCHOLOGIST
NPI 1417958893ActiveIndividual· Psychologist· Stillwater, MN
Psychologist (LIC PSYCHOLOGIST) in Stillwater, Minnesota, licensed in MN, with an NPI issued in August 2005.
Overview
| NPI | 1417958893 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LIC PSYCHOLOGIST |
| Sole proprietor | Yes |
| NPI issued | Aug 9, 2005 |
| Last updated in NPPES | Feb 10, 2021 |
| Certified by provider | Feb 10, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | LP3518 | MN |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | LP3518 | MN |
| Psychologist, Family | 103TF0000X | LP3518 | MN |
| Psychologist, Cognitive & Behavioral | 103TB0200X | LP3518 | MN |
| Psychologist, Counseling | 103TC1900X | LP3518 | 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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