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

Sally Keckeisen

Individual provider Psychologist · NPI 1700566940

Sally Keckeisen is a Clinical Psychologist in Saint Louis Park, Minnesota. Qualified in 2024, 2 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

6600 Excelsior Blvd
Saint Louis Park, MN 55426-4744
Phone: (952) 993-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4815 N Assembly St, Spokane, WA 99205-6185 — (509) 434-7000

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP7268 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700566940
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 21, 2023
Last updated in NPPESOctober 3, 2025
Certification dateOctober 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Saint Louis Park