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PARKSIDE PSYCHOLOGY, INC.
NPI 1114175791
Psychologist - Clinical in Minneapolis, MN

Active since September 08, 2008
2124 DUPONT AVE S, 104, MINNEAPOLIS, MN 55405(612) 871-4336(612) 929-2331 Get Directions Write a Review

NPPES record last updated: September 8, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Parkside Psychology, Inc. NPPES

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

PARKSIDE PSYCHOLOGY, INC. (NPI 1114175791) is a healthcare organization registered as a clinical in Minneapolis, Minnesota and active in the NPI registry since September 2008. The organization lists Sally Ruth Moore, Psychologist/owner, as its authorized official.

NPPES Registry Identity

NPI1114175791
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NamePARKSIDE PSYCHOLOGY, INC.
Location Address2124 DUPONT AVE S, 104Minneapolis, MN 55405-2700
Mailing Address2124 Dupont Ave S, 104Minneapolis, MN 55405-2700 · (612) 871-4336 · Fax (612) 929-2331
Phone(612) 871-4336
Fax(612) 929-2331
Organization SubpartNo
Authorized OfficialSally Ruth MoorePsychologist/owner · (612) 871-4336
Enumeration DateSeptember 8, 2008
✔ NPI 1114175791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · LP1891
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2124 DUPONT AVE S, Minneapolis, MN 55405
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Other Identifiers 3

Other67Q05MOMN · Bcbsmn
Medicaid621853900MN
Medicare PIN68001787MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

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

DR. JULIE A KENFIELD PH.D.
Psychologist
2124 DUPONT AVE S, SUITE 300
MINNEAPOLIS, MN 55405
Hennepin County (612) 879-1010
CARA S BEAMES M.A., L.P.
Psychologist
2124 DUPONT AVE S
MINNEAPOLIS, MN 55405
Hennepin County (612) 874-6640
SARAH KENVILLE
Counselor (Mental Health)
2124 DUPONT AVE S, 101
MINNEAPOLIS, MN 55405
Hennepin County (800) 336-5973
TOWNES, LLC
Clinic/Center (Adult Mental Health)
2124 DUPONT AVE S, SUITE G1
MINNEAPOLIS, MN 55405
Hennepin County (612) 275-7408
MARJORIE SITA LPCC
Counselor (Mental Health)
2124 DUPONT AVE S, SUITE 101
MINNEAPOLIS, MN 55405
Hennepin County (800) 336-5973
DR. ELLEN UDINE LOGACZ PH.D. LP MA LMFT
Marriage & Family Therapist
2124 DUPONT AVE S, SUITE 301
MINNEAPOLIS, MN 55405
Hennepin County (612) 824-9528
KENFIELD AND ASSOCIATES, P.C.
Psychologist
2124 DUPONT AVE S, SUITE 300
MINNEAPOLIS, MN 55405
Hennepin County (612) 879-1010
MRS. JENNIFER EILEEN BROWN MSW, LICSW
Social Worker (Clinical)
2124 DUPONT AVE S
MINNEAPOLIS, MN 55405
Hennepin County (612) 223-7284

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 Parkside Psychology, Inc.'s NPI number?

The NPI number for Parkside Psychology, Inc. is 1114175791. It was assigned to this organization in the NPPES registry on September 8, 2008.

Where is Parkside Psychology, Inc. located?

Parkside Psychology, Inc. is located at 2124 Dupont Ave S 104, Minneapolis, MN 55405. The listed phone number is (612) 871-4336.

What is Parkside Psychology, Inc.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Parkside Psychology, Inc. was last updated on September 8, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.