1. Home
  2. Directory
  3. Minnesota
  4. Mankato
  5. Psychologist
  6. NPI Profile

SURDY PSYCHOLOGICAL SERVICES LLC
NPI 1225576127
Psychologist - Clinical in Mankato, MN

Active since February 10, 2017
1227 CALEDONIA ST, MANKATO, MN 56001(507) 388-8874(507) 625-4807 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 16, 2023, Jan 17, 2023, Mar 27, 2017 and 2 more (5 updates tracked since 2017).

About Surdy Psychological Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SURDY PSYCHOLOGICAL SERVICES LLC (NPI 1225576127), doing business as Mending Roots, is a healthcare organization registered as a clinical in Mankato, Minnesota and active in the NPI registry since February 2017. The organization lists Theodore Surdy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1225576127
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameSURDY PSYCHOLOGICAL SERVICES LLC
Location Address1227 CALEDONIA STMankato, MN 56001-4329
Mailing Address1227 Caledonia StMankato, MN 56001-4329 · (507) 388-8874 · Fax (507) 625-4807
Phone(507) 388-8874
Fax(507) 625-4807
Organization SubpartNo
Authorized OfficialTheodore SurdyCeo · (507) 388-8874
Enumeration DateFebruary 10, 2017
Last NPPES UpdateJanuary 22, 20255 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2025
✔ NPI 1225576127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · LP3385
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1227 CALEDONIA ST, Mankato, MN 56001
Open in Google Maps ↗

Other Names 1

Doing Business AsMending Roots

Other Identifiers 5

Medicaid497823400MN
OtherHP28628MN · Health Partners
Other06T04SUMN · Bxbs
Other114945MN · Ucare Minnesota
Other114945MN · United

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Surdy Psychological Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Surdy Psychological Services LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Theodore Surdy, LPCC
Mental Health Counselor
NPI 1629663919
1207 CALEDONIA ST
Mankato, MN 56001
(507) 388-8874
✔ PECOS✔ Accepts MedicareSame address
Taylor Wester, MS, LPCC
Mental Health Counselor
NPI 1912582032
1207 CALEDONIA ST
Mankato, MN 56001
(507) 388-8874
✔ PECOS✔ Accepts MedicareSame address
Steve Larson, LICSW, MSW
Clinical Social Worker
NPI 1659618650
151 SAINT ANDREWS CT STE 710
Mankato, MN 56001
(507) 386-7121
✔ PECOS2.4 mi
Christina Mellenberger
Mental Health Counselor
NPI 1538633839
512B DEER DR
Henderson, TN 38340
(608) 558-4789
✔ PECOS665 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Surdy Psychological Services LLC's NPI number?

The NPI number for Surdy Psychological Services LLC is 1225576127. It was assigned to this organization in the NPPES registry on February 10, 2017. The provider is doing business as Mending Roots.

Where is Surdy Psychological Services LLC located?

Surdy Psychological Services LLC is located at 1227 Caledonia St, Mankato, MN 56001. The listed phone number is (507) 388-8874.

What is Surdy Psychological Services LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Surdy Psychological Services LLC enrolled in Medicare?

Yes. Surdy Psychological Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Surdy Psychological Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Surdy Psychological Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (3) and Clinical Social Worker (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Surdy Psychological Services LLC accept?

Health plans from HealthPartners and Sanford Health Plan list Surdy Psychological Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Surdy Psychological Services LLC was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.