Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackie Sue Niemand, LIC, PSYCHOLOGIST

Individual provider Clinical Child & Adolescent Psychologist · NPI 1417958893

Jackie Sue Niemand, LIC, PSYCHOLOGIST is a Clinical Child & Adolescent Psychologist in Stillwater, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2005
Specialties on file
5

Practice location Address checks out

6381 Osgood Ave N Ste 8
Stillwater, MN 55082-6182
Phone: (651) 275-9680
Fax: (651) 430-9296
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP3518 (MN)
Clinical Child & Adolescent Psychologist Taxonomy 103TC2200X · Licence LP3518 (MN)
Family Psychologist Taxonomy 103TF0000X · Licence LP3518 (MN)
Cognitive & Behavioral Psychologist Taxonomy 103TB0200X · Licence LP3518 (MN)
Counseling Psychologist Taxonomy 103TC1900X · Licence LP3518 (MN)

Record details

NPI number1417958893
Entity typeIndividual (Type 1)
GenderFemale
Credentials LIC , PSYCHOLOGIST
Sole proprietorYes
NPI enumeratedAugust 9, 2005
Last updated in NPPESFebruary 10, 2021
Certification dateFebruary 10, 2021