SHELLY L EDWARDS (NPI# 1821051327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821051327 |
| Entity Type | Individual |
| Full Name | SHELLY L EDWARDS |
| Credential | MA LP |
| Practice Address |
14115 James Rd Ste 305 Rogers MN 55374-9417 |
| Practice Telephone | 7635758086 |
| Practice Fax Number | 3207740415 |
| Mailing Telephone | 7635758086 |
| Mailing Fax Number | 3207740415 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP3435 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 11Q62ED | 01 |
| MN | 63325900 | 05 | |
| UCARE | 120585 | 01 | |
| HEALTH PARTNERS | HP23171 | 01 | |
| UBH | 6252137 | 01 | |
| PREFERRED ONE | 1023461 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346643 | Shelly Marie Edwards | Homemaker | 7800 Wilkinson Blvd, Charlotte, NC 28214-9148 | 2020-05-06 |
| 1104082569 | Shelly Lynn Edwards | Social Worker | 1333 Wrens Nest Way, Northport, AL 35476-4177 | 2008-08-04 |
| 1902802887 | Shelly J Edwards | Marriage & Family Therapist | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2005-06-24 |
| 1245671122 | Shelly Ann Edwards | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2013-07-08 |
| Street Address |
14115 JAMES RD STE 305 |
| City | ROGERS |
| State | MN |
| Zip Code | 55374-9417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013979848 | Jodi Lynn Sims | Marriage & Family Therapist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2006-04-05 |
| 1023650876 | Corinne Romitti | Social Worker | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2019-10-14 |
| 1164080578 | Ashley Lee Smith | Counselor | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2019-05-31 |
| 1164085387 | Michelle Saari | Counselor | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2019-04-15 |
| 1629543293 | Catherine Jane Harden | Social Worker | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2018-10-09 |
| 1053824748 | Kaylie Broberg | Marriage & Family Therapist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2017-11-16 |
| 1811353329 | Nichola Sue Hoglund | Marriage & Family Therapist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2016-01-13 |
| 1417313339 | Rebecca Gerbig | Social Worker | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2016-01-07 |
| 1407261688 | Jennifer Hollar Berger | Counselor | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2014-06-25 |
| 1801112578 | Darla Jan Dammen | Psychologist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2010-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609335835 | Rebecca Loehrer | Nurse Practitioner | 21370 Ste 210 John Milless Dr., Rogers, MN 55374 | 2019-03-18 |
| 1255722328 | Samantha Colai | Marriage & Family Therapist | 21307 John Milless Drive, Suite 106, Rogers, MN 55374 | 2015-02-11 |
| 1437559648 | Jamie Mosley | Counselor | 2100 Rogers Drive, Suite 200, Rogers, MN 55374 | 2014-08-26 |
| 1295145886 | Marisa Kolasa | Massage Therapist | 22290 Oakdale Drive, Rogers, MN 55374 | 2014-05-05 |
| 1871878165 | Derek P Doty Dc Inc | Chiropractor | 21410 136th Ave N, Suite 105a, Rogers, MN 55374 | 2011-10-18 |
| 1912205865 | Michelle Cheryl Finnegan-larson | Registered Nurse | 21308 John Milless Drive, Rogers, MN 55374 | 2011-03-02 |
| 1639402571 | Ascend Family Institute | Community/Behavioral Health | 20980 Rogers Drive, #400, Rogers, MN 55374 | 2009-09-10 |
| 1275738403 | Nicole M Clements | Physician Assistant | 1355 Rogers Drive, Rogers, MN 55374 | 2007-06-18 |
| 1558566166 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 21455 John Milless Drive, Rogers, MN 55374 | 2007-06-15 |
| 1811062854 | Randall Alvin Hohbein | Pharmacist | 21351 John Milless Drive, Rogers Drug, Rogers, MN 55374 | 2006-11-22 |
| Find all providers in zip 55374 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871748756 | Jean Devenny | Psychologist | 2005 W Elm St, Rogers, AR 72758-4018 | 2008-11-19 |
| 1548385222 | Shona Kathlene Palmer | Psychologist | Center for Psychology, 1601 Rainbow Road, Rogers, AR 72758 | 2007-03-20 |
| 1982742144 | Phyllis Ann Owens | Psychologist | 211151 John Milless Drive, Rogers, MN 56374 | 2007-02-01 |
| 1477582757 | Patricia Heck | Psychologist | 9 Halsted Circle, Rogers, AR 72756 | 2006-06-30 |
| 1205137692 | Tom Umphress | Psychologist | 3307 N Dixieland Rd, Rogers, AR 72756-6816 | 2010-11-16 |
| 1801112578 | Darla Jan Dammen | Psychologist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2010-04-20 |
| 1669577516 | Antoinette R Vanstelten | Psychologist | 14115 James Rd, Ste. 305, Rogers, MN 55374-9468 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493952 | Michelle Brownfield | Psychologist | 606 Spear Ave, Duluth, MN 55803-2154 | 2020-10-01 |
| 1730716994 | Tamolyn Patterson Benke | Psychologist | 8453 Casey Ct, Inver Grove Heights, MN 55076-5154 | 2020-03-26 |
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1134764871 | Avital Ogniewicz | Psychologist | 2519 Commerce Dr Nw, Rochester, MN 55901-4432 | 2019-11-15 |
| 1164065868 | Karen Nicole Chinnock | Psychologist | 930 Blue Gentian Rd, Eagan, MN 55121-1674 | 2019-10-25 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1083257349 | Nathaniel Page | Psychologist | 2423 Valley Dr, Northfield, MN 55057-3224 | 2019-10-18 |
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1881243590 | Bill Clafton Psyd Lp LLC | Psychologist | 1755 Old West Main St Ste 204, Red Wing, MN 55066-3057 | 2019-09-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.