Matthew E. Ballenthin, PSYD. LP
NPI 1861745176ActiveIndividual· Psychologist· Lake Elmo, MN
Psychologist (PSYD. LP) in Lake Elmo, Minnesota, licensed in MN, with an NPI issued in October 2012. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1861745176 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD. LP |
| Sole proprietor | No |
| NPI issued | Oct 24, 2012 |
| Last updated in NPPES | Mar 9, 2021 |
| Certified by provider | Mar 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | LP5527 | MN |
| Psychologist, Clinical | 103TC0700X | LP5527 | 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) |
|---|
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