NORTH PSYCHOLOGY CLINIC PA NPI 1265462212

NPI Information

NPI: 1265462212
Provider Name: NORTH PSYCHOLOGY CLINIC PA
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
6120 EARLE BROWN DRIVE STE. 520
NORTH PSYCHOLOGY CLINIC P.A.
BROOKLYN CENTER, MN
ZIP 55430
Phone: (763) 531-0566
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NORTH PSYCHOLOGY CLINIC PA is a mental health (including community mental health center) clinic center in Brooklyn Center, MN. NORTH PSYCHOLOGY CLINIC PA NPI is 1265462212. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6120 EARLE BROWN DRIVE STE. 520
NORTH PSYCHOLOGY CLINIC P.A.
BROOKLYN CENTER, MN
ZIP 55430-123
Phone: (763) 531-0566
Fax: (763) 531-0602

The provider's authorized official is Diane K. Felton .
The authorized official title is President and has the following contact phone number (763) 531-0566.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 10/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist				No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)		MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	68001777	MEDICARE PIN	MINNESOTA
2	30786NO	OTHER	MINNESOTA	BLUE CROSS BLUE SHIEL
3	30787NO	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
4	973518600	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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