Lakeside Psychology Services, Llc

LBN: Lakeside Psychology Services, Llc
Lakeside Psychology Services, Llc is an health care organization with primary practice located at 4601 Excelsior Blvd Ste 340 , St Louis Park MN 55416-5228. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Lakeside Psychology Services, Llc can be contacted via phone (612) 217-2719, or through Mckay, Julie Anne via phone (612) 217-2719.

Contact Information

Primary practice address
4601 Excelsior Blvd Ste 340 St Louis Park MN 55416-5228
Phone: (612) 217-2719
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mckay, Julie Anne PSY.D., LP
Phone: (612) 217-2719

Health care specialties

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

Profile Details

NPI number 1174171649
LBN Legal business name Lakeside Psychology Services, Llc
DBA Doing business as
Authorized official Mckay, Julie Anne PSY.D., LP
Entity Organization
Organization subpart 1 No
Enumeration date Aug 28th, 2019
Last updated Oct 4th, 2022 - about 3 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 1174171649 NPPES
Minnesota MEDICAID 1629410139

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