DR. DEVON E. WHITEHEAD (PH.D.) – Psychologist, NPI 1003037458

DR. DEVON E. WHITEHEAD (PH.D.) is a healthcare provider. based in Champlin, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 5603 (MN). The NPI Number for DR. DEVON E. WHITEHEAD (PH.D.) is 1003037458

Main info

Female
15 Years Of Experience
Name
DR. DEVON E. WHITEHEAD (PH.D.)
NPI
1003037458
Phone
(763) 531-0566
Address
11165 ZEALAND AVE N
Enumeration Date
2 May 2007
Last Update Date
15 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635310566106
Graduation Year
2011 (15 years ago)
PAC ID
9335387216
Group Practice PAC ID
3870545668
Professional Enrollment ID
I20130606000524
Address ID
MN553163595CH11165NXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. DEVON E. WHITEHEAD (PH.D.)

  • 11165 ZEALAND AVE N

    CHAMPLIN, MN 553163595

    Phone: (763) 531-0566

    Fax: (763) 531-0602

    Type: Location

  • 11165 Zealand Ave N

    Champlin, MN 553163595

    Phone: (763) 531-0566

    Fax: (763) 531-0602

    Type: Location

  • 1321 13TH ST N

    SAINT CLOUD, MN 563032613

    Phone: (330) 252-5010

    Type: Mailing

  • 299 COON RAPIDS BLVD NE

    SUITE 100

    COON RAPIDS, MN 55344

    Phone: (651) 240-2206

    Fax: (612) 446-5766

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-06-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130606000524IClinical PsychologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55316)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870545668View full group profile
NameSpecialtyState
Clinical PsychologistMN
Marriage And Family TherapistMN
Clinical PsychologistMN
-MN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Is DR. DEVON E. WHITEHEAD (PH.D.) listed with a National Provider Identifier?
Yes — DR. DEVON E. WHITEHEAD (PH.D.) has NPI 1003037458 on file in the registry.
Is DR. DEVON E. WHITEHEAD (PH.D.) still an active registrant?
DR. DEVON E. WHITEHEAD (PH.D.) carries an active NPI according to the public dataset.
What kind of doctor is DR. DEVON E. WHITEHEAD (PH.D.)?
DR. DEVON E. WHITEHEAD (PH.D.) is associated with Psychologist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. DEVON E. WHITEHEAD (PH.D.)?
Travel planning: use Champlin, Minnesota as the reference point for DR. DEVON E. WHITEHEAD (PH.D.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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