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ELIZABETH WAGNER PSYD LP INC. NPI 1740637818


NPI Information

NPI: 1740637818
Provider Name: ELIZABETH WAGNER, PSYD, LP, INC.

Doing Business As: ELEOS PSYCHOLOGY CENTER

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
4500 PARK GLEN RD
SUITE 450
SAINT LOUIS PARK, MN
ZIP 55416
Phone: (952) 444-9744
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ELIZABETH WAGNER, PSYD, LP, INC. is a clinical psychologist in Saint Louis Park, MN. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. ELIZABETH WAGNER, PSYD, LP, INC. NPI is 1740637818. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Eleos Psychology Center.

The provider's business location address is:

4500 PARK GLEN RD
SUITE 450
SAINT LOUIS PARK, MN
ZIP 55416-871
Phone: (952) 444-9744
Fax: (952) 444-9745

The provider's authorized official is Elizabeth Wagner .
The authorized official title is Chief Executive Officer and has the following contact phone number (952) 444-9744.

The enumeration date for this NPI number is 5/19/2016 and was last updated on 7/1/2016.


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
1103TC0700XPsychologistClinical5833MINNESOTAYes

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

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