| Laidlaw Psychological Services, Plc | |
|
3301 30th Ave S Ste 101 Grand Forks ND 58201-6009 | |
| (701) 780-9700 | |
| (701) 780-9709 |
| Full Name | Laidlaw Psychological Services, Plc |
|---|---|
| Speciality | Psychologist |
| Location | 3301 30th Ave S Ste 101, Grand Forks, North Dakota |
| Authorized Official Name and Position | Robert A Laidlaw (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7017809700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laidlaw Psychological Services, Plc 3301 30th Ave S Ste 101 Grand Forks ND 58201-6009 Ph: (701) 780-9700 | Laidlaw Psychological Services, Plc 3301 30th Ave S Ste 101 Grand Forks ND 58201-6009 Ph: (701) 780-9700 |
| NPI Number | 1699859173 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 04/18/2014 |
| Medicare PECOS PAC ID | 8921070343 |
|---|---|
| Medicare Enrollment ID | O20040806000958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699859173 | NPI | - | NPPES |
| N711209 | Other | ND | MEDICARE PART B |
| 012274 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 204 (North Dakota) | Primary |
| Provider Name | Robert A. Laidlaw |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629031166 PECOS PAC ID: 5092787416 Enrollment ID: I20110119001318 |
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