Lakes Psychological Practice, Llc

LBN: Lakes Psychological Practice, Llc
Lakes Psychological Practice, Llc is an health care organization with primary practice located at 100 Fuller St S , Shakopee MN 55379-1348. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Lakes Psychological Practice, Llc can be contacted via phone (612) 568-1475, or through Mohammed, Anisa Sophia via phone (612) 568-1475.

Contact Information

Primary practice address
100 Fuller St S Shakopee MN 55379-1348
Phone: (612) 568-1475
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mohammed, Anisa Sophia PSYD, LP
Phone: (612) 568-1475

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP5667 Minnesota

Profile Details

NPI number 1194232264
LBN Legal business name Lakes Psychological Practice, Llc
DBA Doing business as
Authorized official Mohammed, Anisa Sophia PSYD, LP
Entity Organization
Organization subpart 1 No
Enumeration date Jan 10th, 2018
Last updated Jan 10th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194232264 NPPES
Minnesota MEDICAID 1215364625

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