| Lacuna For Integrative Therapies | |
|
5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 | |
| (612) 360-5685 | |
| (952) 285-4103 |
| Full Name | Lacuna For Integrative Therapies |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 5009 Excelsior Blvd, St. Louis Park, Minnesota |
| Authorized Official Name and Position | Joshua M Kent (LICSW) |
| Authorized Official Contact | 6512640260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacuna For Integrative Therapies 5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 Ph: (612) 360-5685 | Lacuna For Integrative Therapies 5009 Excelsior Blvd Suite 134 St. Louis Park MN 55416 Ph: (612) 360-5685 |
| NPI Number | 1629108410 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629108410 | NPI | - | NPPES |
| 607649100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 15118 (Minnesota) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 15118 (Minnesota) | Primary |
The Lake Group Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Park Glen Road #155, St. Louis Park, MN 55416 Phone: 612-223-7992 Fax: 952-928-9774 | |
Wayside House, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1349 Jersey Ave S, St. Louis Park, MN 55426 Phone: 952-542-9322 Fax: 952-542-0031 |