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Contact Information

JACKIE S NIEMAND, LIC PSYCHOLOGIST
6381 OSGOOD AVE N STE 8
STILLWATER, MN55082-6182
 Phone: 651-275-9680
 Fax: 651-430-9296
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Counseling

103TC1900X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JACKIE S NIEMAND · (Female)

NPI # 1417958893
Status Active
Credentials LIC PSYCHOLOGIST
Entity Individual
Enumeration date 08/09/2005
Last updated 02/10/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # LP3518
  • MN Medicaid 154015700
  • MN Other 56B45NI BLUE CROSS BLUE SHIELD MN
  • MN Other 6236625 UNITED BEHAVIORAL HEALTH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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