DR. LISA WILKE PSYD
NPI 1760927784
Psychologist in Champlin, MN

Active since December 29, 2016PECOS Enrolled
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316(763) 236-0600(763) 236-0790 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2025, Dec 29, 2016 (2 updates tracked since 2016).

About Dr. Lisa Wilke Psyd NPPES

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

DR. LISA WILKE PSYD (NPI 1760927784) is an individual psychologist in Champlin, Minnesota, licensed in Minnesota (LP6237) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1760927784
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. LISA WILKECredential: PSYD
Location Address11269 JEFFERSON HWY NChamplin, MN 55316-3123
Mailing AddressPo Box 206Minneapolis, MN 55480-0206 · (612) 262-9000
Fax(763) 236-0790
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateDecember 29, 2016
Last NPPES UpdateApril 1, 20252 updates tracked since enumeration
NPPES CertifiedApril 1, 2025
NPI 1760927784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP6237
Definition
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.
11269 JEFFERSON HWY N, Champlin, MN 55316

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Lisa Wilke Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375064595
PECOS Enrollment IDI20251009003260
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Family Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Obstetrics & Gynecology
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Nurse Practitioner
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Family Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Family Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Nurse Practitioner (Family)
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Family Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316

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 Lisa Wilke's NPI number?

The NPI number for Lisa Wilke is 1760927784. It was assigned to this individual provider in the NPPES registry on December 29, 2016.

Where is Lisa Wilke located?

Lisa Wilke practices at 11269 Jefferson Hwy N, Champlin, MN 55316. The listed phone number is (763) 236-0600.

What is Lisa Wilke's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Lisa Wilke enrolled in Medicare?

Yes. Lisa Wilke is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lisa Wilke was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.