DR. KRISTIN LYNN NELSON (PSY.D.) – Student in an Organized Health Care Education/Training Program, NPI 1205105426

DR. KRISTIN LYNN NELSON (PSY.D.) is a healthcare provider. based in Saint paul, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. The NPI Number for DR. KRISTIN LYNN NELSON (PSY.D.) is 1205105426

Main info

Female
Sole Proprietor
15 Years Of Experience
Name
DR. KRISTIN LYNN NELSON (PSY.D.)
NPI
1205105426
Phone
(651) 644-4100
Address
2383 UNIVERSITY AVE W
Enumeration Date
16 December 2011
Last Update Date
16 December 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516444100
Graduation Year
2011 (15 years ago)
PAC ID
1052541372
Group Practice PAC ID
2264583954
Professional Enrollment ID
I20140307000010
Address ID
MN551141854SA2324XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:14State licenses:0Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

Provider Addresses for DR. KRISTIN LYNN NELSON (PSY.D.)

  • 2383 UNIVERSITY AVE W

    200

    SAINT PAUL, MN 551141603

    Phone: (651) 644-4100

    Fax: (651) 644-4885

    Mailing address matches the actual address.

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: 2014-03-07

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
I20140307000010IClinical 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 55114)

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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: 2264583954View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN
Mental Health CounselorTX
Clinical PsychologistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

Is DR. KRISTIN LYNN NELSON (PSY.D.) listed with a National Provider Identifier?
Yes — DR. KRISTIN LYNN NELSON (PSY.D.) has NPI 1205105426 on file in the registry.
Is there an active status for DR. KRISTIN LYNN NELSON (PSY.D.)?
For scheduling context, DR. KRISTIN LYNN NELSON (PSY.D.) is shown as active in the registry.
What clinical focus is listed for DR. KRISTIN LYNN NELSON (PSY.D.)?
At a glance, DR. KRISTIN LYNN NELSON (PSY.D.) is tied to Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
Is DR. KRISTIN LYNN NELSON (PSY.D.) associated with Saint Paul?
Public fields place DR. KRISTIN LYNN NELSON (PSY.D.) around Saint Paul, Minnesota. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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