| Lakeville Behavioral Health, Llc | |
|
10535 165th St W Lakeville MN 55044-5729 | |
| (952) 435-0022 | |
| (952) 435-0095 |
| Full Name | Lakeville Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 10535 165th St W, Lakeville, Minnesota |
| Authorized Official Name and Position | Dale Knute Lokkesmoe (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9524350022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeville Behavioral Health, Llc 10535 165th St W Lakeville MN 55044-5729 Ph: (952) 435-0022 | Lakeville Behavioral Health, Llc 10535 165th St W Lakeville MN 55044-5729 Ph: (952) 435-0022 |
| NPI Number | 1750412680 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 07/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750412680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | LP3587 (Minnesota) | Primary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | LP1249 (Minnesota) | Secondary |
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