LAKESIDE PSYCHOLOGY SERVICES, LLC
NPI 1174171649
Psychologist in St Louis Park, MN

Active since August 28, 2019
4601 EXCELSIOR BLVD STE 340, ST LOUIS PARK, MN 55416(612) 217-2719 Get Directions Write a Review

NPPES record last updated: October 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 4, 2022, May 22, 2020, Aug 28, 2019 (3 updates tracked since 2019).

About Lakeside Psychology Services, Llc NPPES

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

LAKESIDE PSYCHOLOGY SERVICES, LLC (NPI 1174171649) is a healthcare organization registered as a psychologist in St Louis Park, Minnesota and active in the NPI registry since August 2019. The organization lists Julie Anne Mckay, Licensed Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1174171649
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameLAKESIDE PSYCHOLOGY SERVICES, LLC
Location Address4601 EXCELSIOR BLVD STE 340St Louis Park, MN 55416-5228
Mailing Address4601 Excelsior Blvd Ste 340St Louis Park, MN 55416-5228 · (612) 217-2719 · Fax (612) 208-8333
Organization SubpartNo
Authorized OfficialJulie Anne MckayLicensed Clinical Psychologist · (612) 217-2719
Enumeration DateAugust 28, 2019
Last NPPES UpdateOctober 4, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2022
NPI 1174171649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
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.
4601 EXCELSIOR BLVD STE 340, St Louis Park, MN 55416

Other Identifiers 1

Medicaid1629410139MN

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

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

Psychologist (Clinical)
4601 EXCELSIOR BLVD STE 340
ST LOUIS PARK, MN 55416

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 Lakeside Psychology Services, LLC's NPI number?

The NPI number for Lakeside Psychology Services, LLC is 1174171649. It was assigned to this organization in the NPPES registry on August 28, 2019.

Where is Lakeside Psychology Services, LLC located?

Lakeside Psychology Services, LLC is located at 4601 Excelsior Blvd Ste 340, St Louis Park, MN 55416. The listed phone number is (612) 217-2719.

What is Lakeside Psychology Services, LLC'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 Lakeside Psychology Services, LLC was last updated on October 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.