MARY BETH SCANLON (PHD, LP) – Psychologist, NPI 1366405367

MARY BETH SCANLON (PHD, LP) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD, LP. They hold a License No. LP1288 (MN). The NPI Number for MARY BETH SCANLON (PHD, LP) is 1366405367

Main info

Female
36 Years Of Experience
Accepts Medicare Assignment
Name
MARY BETH SCANLON (PHD, LP)
NPI
1366405367
Phone
(612) 262-4813
Address
PO BOX 43
Enumeration Date
10 April 2006
Last Update Date
11 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3206825225
Graduation Year
1990 (36 years ago)
PAC ID
2163698663
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20120105000175
Address ID
MN553021109AN440XXEXXX400
Telehealth
Yes

Contacts

Secure Messaging
mscanlon11554@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for MARY BETH SCANLON (PHD, LP)

  • PO BOX 43

    MR 10809

    MINNEAPOLIS, MN 554400043

    Phone: (612) 262-4813

    Fax: (612) 262-4194

    Type: Mailing

  • Alina Medical Clinic Eagan, 1110, Yankee Doodle Road, Eagan, Dakota County, Minnesota, 55121, United States

    EAGAN, MN 551212092

    Phone: (651) 454-3970

    Fax: (651) 241-0059

    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: 2012-01-05

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
I20120105000175IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes11416$0
90791Psychiatric diagnostic evaluation1515$0
View full utilization report →

Insurance plans in this area (ZIP 55440)

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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: 4587573613View full group profile

Reviews

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Frequently asked questions

Does MARY BETH SCANLON (PHD, LP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MARY BETH SCANLON (PHD, LP) uses 1366405367.
Does the file indicate MARY BETH SCANLON (PHD, LP) is practicing under active NPI?
Directory data currently reports MARY BETH SCANLON (PHD, LP) as active.
What taxonomy line describes MARY BETH SCANLON (PHD, LP)?
For research purposes, treat MARY BETH SCANLON (PHD, LP) as Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is MARY BETH SCANLON (PHD, LP) based?
MARY BETH SCANLON (PHD, LP) is tied to Minneapolis, Minnesota in the data we show; additional addresses may exist on the full record.
Why does MARY BETH SCANLON (PHD, LP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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