Jared S. Spencer
NPI 1477199636ActiveIndividual· Psychologist, Clinical· Prior Lake, MN
Psychologist, Clinical with Lorenz Clinic LLC, practicing in Prior Lake, Minnesota. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1477199636 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Nov 22, 2019 |
| Last updated in NPPES | Jul 7, 2021 |
| Certified by provider | Jul 7, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP6688 | MN |
| Psychologist, Clinical | 103TC0700X | 071.010179 | IL |
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 | 2018 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Lorenz Clinic LLCWayzata, MN · 23 clinicians
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