| Child Psychology Services, Llc | |
|
12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 | |
| (612) 284-1557 | |
| (952) 432-3826 |
| Full Name | Child Psychology Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12940 Harriet Ave S, Burnsville, Minnesota |
| Authorized Official Name and Position | Laura Sullivan Ehlert (PSYCHOLOGIST) |
| Authorized Official Contact | 6122841557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Psychology Services, Llc 12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 Ph: (612) 284-1557 | Child Psychology Services, Llc 12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 Ph: (612) 284-1557 |
| NPI Number | 1609095629 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 06/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609095629 | NPI | - | NPPES |
| 66G85CH | Other | MN | BLUE CROSS BUSINESS |
| 218191033686 | Other | MN | PREFERRED ONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP5415 (Minnesota) | Primary |
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