WATERSHED PSYCHOLOGICAL SERVICES is a mental health (including community mental health center) clinic center in Blaine, MN. WATERSHED PSYCHOLOGICAL SERVICES NPI is 1952763351. The provider is registered as an organization entity type.
The provider's business location address is:
4255 PHEASANT RIDGE DRIVE SUITE 412 BLAINE, MN ZIP 55391 Phone: (763) 317-6222 Fax: (763) 307-3835
The provider's authorized official is Megan Jean Boom Shedlock . The authorized official title is Co-owner and has the following contact phone number (320) 266-4535.
The enumeration date for this NPI number is 3/24/2016 and was last updated on 8/8/2016.
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:
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: 3/30/2025
NPI Synchronization or Removal
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