| Lumen Psychological Services, Llc | |
|
3503 Highpoint Dr N Ste 230 Oakdale MN 55128-7577 | |
| (612) 787-7050 | |
| Not Available |
| Full Name | Lumen Psychological Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3503 Highpoint Dr N Ste 230, Oakdale, Minnesota |
| Authorized Official Name and Position | Britt Nicole Shackelford Wessel (MEMBER / PROVIDER) |
| Authorized Official Contact | 6127877050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumen Psychological Services, Llc 3503 Highpoint Dr N Ste 230 Oakdale MN 55128-7577 Ph: (612) 787-7050 | Lumen Psychological Services, Llc 3503 Highpoint Dr N Ste 230 Oakdale MN 55128-7577 Ph: (612) 787-7050 |
| NPI Number | 1457628877 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 02/17/2021 |
| Certification Date | 02/17/2021 |
| Medicare PECOS PAC ID | 2567620743 |
|---|---|
| Medicare Enrollment ID | O20120220000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457628877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP 5297 (Minnesota) | Primary |
| Provider Name | Britt N S Wessel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871805614 PECOS PAC ID: 5496944951 Enrollment ID: I20110113001215 |
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