Brent Anderson, PSYD
NPI 1518471382ActiveIndividual· Psychologist· St Louis Park, MN
Psychologist (PSYD) with Park Nicollet Clinic, practicing in St Louis Park, Minnesota. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1518471382 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | Nov 30, 2017 |
| Last updated in NPPES | Mar 12, 2021 |
| Certified by provider | Mar 12, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | LP6175 | — |
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 | 2016 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Park Nicollet ClinicSt Louis Park, MN · 1,787 clinicians
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