| Act Psychological Services, Pllc | |
|
4601 Excelsior Blvd Ste 507a Saint Louis Park MN 55416-4977 | |
| (612) 836-3886 | |
| Not Available |
| Full Name | Act Psychological Services, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4601 Excelsior Blvd Ste 507a, Saint Louis Park, Minnesota |
| Authorized Official Name and Position | Kent David Smallwood (CLINICAL LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6128363886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Act Psychological Services, Pllc 1028 Pike Lake Dr New Brighton MN 55112-2427 Ph: (612) 836-3886 | Act Psychological Services, Pllc 4601 Excelsior Blvd Ste 507a Saint Louis Park MN 55416-4977 Ph: (612) 836-3886 |
| NPI Number | 1407296288 |
|---|---|
| Provider Enumeration Date | 06/26/2013 |
| Last Update Date | 06/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407296288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LP5358 (Minnesota) | Primary |
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