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CHILD PSYCHOLOGY SERVICES LLC NPI 1609095629


NPI Information

NPI: 1609095629
Provider Name: CHILD PSYCHOLOGY SERVICES, LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
12940 HARRIET AVE S
SUITE 250
BURNSVILLE, MN
ZIP 55337
Phone: (612) 284-1557
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CHILD PSYCHOLOGY SERVICES, LLC is a community behavioral health in Burnsville, MN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CHILD PSYCHOLOGY SERVICES, LLC NPI is 1609095629. The provider is registered as an organization entity type.

The provider's business location address is:

12940 HARRIET AVE S
SUITE 250
BURNSVILLE, MN
ZIP 55337-680
Phone: (612) 284-1557
Fax: (952) 432-3826

The provider's authorized official is Laura Sullivan Ehlert .
The authorized official title is Psychologist and has the following contact phone number (612) 284-1557.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 6/19/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthLP5415MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1218191033686OTHERMINNESOTAPREFERRED ONE
266G85CHOTHERMINNESOTABLUE CROSS BUSINESS

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: 4/28/2024

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