STONE ARCH PSYCHOLOGY AND HEALTH SERVICES – Clinical Psychologist, NPI 1124398607

STONE ARCH PSYCHOLOGY AND HEALTH SERVICES is a healthcare provider. based in Minneapolis, Minnesota. specializing in Clinical Psychologist. The organization holds a License No. LP3594 (MN). The NPI Number for STONE ARCH PSYCHOLOGY AND HEALTH SERVICES is 1124398607

Main info

Organization
Name
STONE ARCH PSYCHOLOGY AND HEALTH SERVICES
NPI
1124398607
Phone
(612) 886-2524
Address
219 MAIN ST SE STE 400
Authorized Official
MS. SUSAN GUSTAFSON PSYCHOLOGIST PSD. LP.
Enumeration Date
30 December 2011
Last Update Date
11 June 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for STONE ARCH PSYCHOLOGY AND HEALTH SERVICES

  • 219 MAIN ST SE STE 400

    MINNEAPOLIS, MN 554142151

    Phone: (612) 886-2524

    Fax: (612) 886-2538

    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: 2012-03-12

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
O20120312000071OClinic/Group PracticeMNTBD

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 55414)

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Reviews

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Frequently asked questions

What number should I use to identify STONE ARCH PSYCHOLOGY AND HEALTH SERVICES for billing?
Administrative and clinical systems typically use NPI 1124398607 for STONE ARCH PSYCHOLOGY AND HEALTH SERVICES.
Is STONE ARCH PSYCHOLOGY AND HEALTH SERVICES's NPI status active today?
Active status means STONE ARCH PSYCHOLOGY AND HEALTH SERVICES's NPI record is not deactivated in the public file.
What type of care does STONE ARCH PSYCHOLOGY AND HEALTH SERVICES provide?
STONE ARCH PSYCHOLOGY AND HEALTH SERVICES's profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is STONE ARCH PSYCHOLOGY AND HEALTH SERVICES tied to Minneapolis, Minnesota?
If you are local to Minneapolis, Minnesota, STONE ARCH PSYCHOLOGY AND HEALTH SERVICES may be relevant to your search.
Who maintains STONE ARCH PSYCHOLOGY AND HEALTH SERVICES's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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