NPI Details
THE LAKE GROUP LLC is a psychologist in St. Louis Park, MN. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. THE LAKE GROUP LLC NPI is 1346471232. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mound Psychological Services.
The provider's business location address is:
4500 PARK GLEN ROAD #155
ST. LOUIS PARK, MN
ZIP 55416
Phone: (612) 223-7992
Fax: (952) 928-9774
The provider's authorized official is Bettina Stuecher .
The authorized official title is Owner and has the following contact phone number (651) 235-6493.
The enumeration date for this NPI number is 7/27/2009 and was last updated on 11/11/2024.
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 | 101YP2500X | Counselor | Professional | | | No |
| 2 | 103T00000X | Psychologist | | | | Yes |
| 3 | 103TC0700X | Psychologist | Clinical | | | No |
| 4 | 1041C0700X | Social Worker | Clinical | | | No |
| 5 | 106H00000X | Marriage & Family Therapist | | | | No |
| 6 | 133N00000X | Nutritionist | | | | No |
| 7 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
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 | 5H617PO | OTHER | MINNESOTA | BLUE CROSS |
