| Novo Psychological Services, Llc | |
|
720 Viking Dr E Maplewood MN 55117-1666 | |
| (612) 710-9297 | |
| Not Available |
| Full Name | Novo Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 720 Viking Dr E, Maplewood, Minnesota |
| Authorized Official Name and Position | Paul Novotny (PSYCHOLOGIST, PRESIDENT & CEO) |
| Authorized Official Contact | 6127109297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Novo Psychological Services, Llc 720 Viking Dr E Maplewood MN 55117-1666 Ph: () - | Novo Psychological Services, Llc 720 Viking Dr E Maplewood MN 55117-1666 Ph: (612) 710-9297 |
| NPI Number | 1053719732 |
|---|---|
| Provider Enumeration Date | 12/12/2014 |
| Last Update Date | 12/12/2014 |
| Medicare PECOS PAC ID | 7911222054 |
|---|---|
| Medicare Enrollment ID | O20150211001704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053719732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP5731 (Minnesota) | Primary |
| Provider Name | Paul M Novotny |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609102870 PECOS PAC ID: 5092030148 Enrollment ID: I20150807014567 |
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