LAKES PSYCHOLOGICAL PRACTICE, LLC
NPI 1194232264
Psychologist in Shakopee, MN

Active since January 10, 2018
100 FULLER ST S, SHAKOPEE, MN 55379(612) 568-1475 Get Directions Write a Review

NPPES record last updated: January 10, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lakes Psychological Practice, Llc NPPES

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

LAKES PSYCHOLOGICAL PRACTICE, LLC (NPI 1194232264) is a healthcare organization registered as a psychologist in Shakopee, Minnesota and active in the NPI registry since January 2018. The organization lists Anisa Sophia Mohammed, Psychologist, as its authorized official.

NPPES Registry Identity

NPI1194232264
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameLAKES PSYCHOLOGICAL PRACTICE, LLC
Location Address100 FULLER ST SShakopee, MN 55379-1348
Mailing Address3248 Stevens AveMinneapolis, MN 55408-3214 · (813) 401-7624
Organization SubpartNo
Authorized OfficialAnisa Sophia MohammedPsychologist · (612) 568-1475
Enumeration DateJanuary 10, 2018
NPI 1194232264 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 · LP5667
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.
100 FULLER ST S, Shakopee, MN 55379

Other Identifiers 1

Medicaid1215364625MN

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 5

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

Social Worker
100 FULLER ST S
SHAKOPEE, MN 55379
Counselor
100 FULLER ST S
SHAKOPEE, MN 55379
Home Health
100 FULLER ST S, SUITE 220
SHAKOPEE, MN 55379
Psychologist
100 FULLER ST S
SHAKOPEE, MN 55379
Hearing Instrument Specialist
100 FULLER ST S, SUITE 135
SHAKOPEE, MN 55379

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 Lakes Psychological Practice, LLC's NPI number?

The NPI number for Lakes Psychological Practice, LLC is 1194232264. It was assigned to this organization in the NPPES registry on January 10, 2018.

Where is Lakes Psychological Practice, LLC located?

Lakes Psychological Practice, LLC is located at 100 Fuller St S, Shakopee, MN 55379. The listed phone number is (612) 568-1475.

What is Lakes Psychological Practice, 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 Lakes Psychological Practice, LLC was last updated on January 10, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.