Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KENNETH GERARD FOGAL MS VP
NPI 1104800960
Psychologist in Crosby, MN

Active since December 05, 2005
318 E MAIN ST, CENTRAL LAKES MEDICAL CLINIC ,PA, CROSBY, MN 56441(218) 546-8375(218) 546-4400 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth Gerard Fogal Ms Vp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH GERARD FOGAL MS VP (NPI 1104800960) is an individual psychologist in Crosby, Minnesota, licensed in Minnesota (LP0270) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1104800960
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameKENNETH GERARD FOGALCredential: MS VP
Location Address318 E MAIN ST, CENTRAL LAKES MEDICAL CLINIC ,PACrosby, MN 56441-1691
Mailing Address318 E Main StCrosby, MN 56441-1691 · (218) 546-8375 · Fax (218) 546-4400
Fax(218) 546-4400
Sole ProprietorNo
Enumeration DateDecember 5, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1104800960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP0270
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
318 E MAIN ST, Crosby, MN 56441

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Audiologist
318 E MAIN ST, CENTRAL LAKES MEDICAL CLINIC PA
CROSBY, MN 56441
Physician Assistant
318 E MAIN ST
CROSBY, MN 56441
Family Medicine
318 E MAIN ST
CROSBY, MN 56441
Emergency Medicine
318 E MAIN ST
CROSBY, MN 56441
Otolaryngology
318 E MAIN ST
CROSBY, MN 56441
Clinic/Center
318 E MAIN ST
CROSBY, MN 56441

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Fogal's NPI number?

The NPI number for Kenneth Fogal is 1104800960. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is Kenneth Fogal located?

Kenneth Fogal practices at 318 E Main St Central Lakes Medical Clinic ,pa, Crosby, MN 56441. The listed phone number is (218) 546-8375.

What is Kenneth Fogal's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Fogal was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.