| Northern Lights Psychological Services P.a. | |
|
1010 Frontier Dr Suite 104 Fergus Falls MN 56537-1023 | |
| (507) 828-1433 | |
| Not Available |
| Full Name | Northern Lights Psychological Services P.a. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1010 Frontier Dr, Fergus Falls, Minnesota |
| Authorized Official Name and Position | Angela A Kennedy (CEO) |
| Authorized Official Contact | 5078281433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Lights Psychological Services P.a. Po Box 3 Underwood MN 56586-0003 Ph: (507) 828-1433 | Northern Lights Psychological Services P.a. 1010 Frontier Dr Suite 104 Fergus Falls MN 56537-1023 Ph: (507) 828-1433 |
| NPI Number | 1619229754 |
|---|---|
| Provider Enumeration Date | 10/14/2012 |
| Last Update Date | 10/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619229754 | NPI | - | NPPES |
| 6178609 | Other | MN | MEDICA |
| 589175200 | Medicaid | MN | |
| 978T6PS | Other | BCBS OF MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP4330 (Minnesota) | Primary |
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