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Deactivated NPI 1942359708 Deactivated / Inactive NPI Male Practitioner

Grant M Berg , MA, LP

Psychologist • Minneapolis, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Grant Berg has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 10, 2007
NPI Deactivation Date October 09, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Grant Berg, MA, LP was a registered Psychologist practicing in Minneapolis, MN. Throughout an active medical career spanning 18 years, Grant Berg provided care at the practice location at 1801 NICOLLET AVE until profile deactivation on 2025-10-09.

Practice Location & Contact Primary Location

Practice Address

1801 Nicollet Ave

Minneapolis, MN 554033793

Telephone 6125960900
Fax 6128793823
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Minneapolis, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.4 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
352 Specialists

Practicing in Minneapolis, MN (1833 Statewide)

Telehealth Adoption Rate
12.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MN LP3504

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners
Darlene Sholtis

Psychologist - Clinical

NPI 1043320625
Dr. Harvey Linder , PhD, LP

Psychologist - Clinical

NPI 1043479959

Doctor of Philosophy (Ph.D.), Licensed Psychologist

Paul Traugh , LICSW

Social Worker - Clinical

NPI 1043525801

Licensed Independent Clinical Social Worker

Carole White

Social Worker - Clinical

NPI 1053416974
Mary Cichon

Psychologist - Clinical

NPI 1114037702
Pamela Piwko , OT

Occupational Therapist

NPI 1124295217

Occupational Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 09, 2025

Record deactivated on October 09, 2025

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 1801 NICOLLET AVE, MINNEAPOLIS, MN 554033793 (Tel: 6125960900)

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Updated Business Mailing Address July 09, 2007

Registered at 1801 NICOLLET AVE, MINNEAPOLIS, MN 554033793 (Tel: 6125960900)

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Provider Name / Credentials Updated July 09, 2007

Recorded as GRANT BERG, MA, LP

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Psychologist (License #LP3504 in MN)

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Initial NPI Registration & Enumeration January 10, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1942359708
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2007
Last Update: July 09, 2007
Deactivation Date: October 09, 2025

Mailing Address

1801 Nicollet Ave

Minneapolis, MN 554033793

Phone: 6125960900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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