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LAKE SUPERIOR PSYCHOLOGICAL SERVICES, INC.
NPI 1396089660
Community/Behavioral Health in Hermantown, MN

Active since November 26, 2012
4891 MILLER TRUNK HWY, SUITE 106, HERMANTOWN, MN 55811(218) 722-2525(218) 722-1033 Get Directions Write a Review

NPPES record last updated: February 6, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lake Superior Psychological Services, Inc. NPPES

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

LAKE SUPERIOR PSYCHOLOGICAL SERVICES, INC. (NPI 1396089660) is a healthcare organization registered as a community/behavioral health in Hermantown, Minnesota and active in the NPI registry since November 2012. The organization lists Jeffrey Lynn Olson, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1396089660
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameLAKE SUPERIOR PSYCHOLOGICAL SERVICES, INC.
Location Address4891 MILLER TRUNK HWY, SUITE 106Hermantown, MN 55811-1512
Mailing Address4891 Miller Trunk Hwy, Suite 106Hermantown, MN 55811-1512 · (218) 722-2525 · Fax (218) 722-1033
Phone(218) 722-2525
Fax(218) 722-1033
Organization SubpartNo
Authorized OfficialJeffrey Lynn OlsonClinical Psychologist · (218) 722-2525
Enumeration DateNovember 26, 2012
Last NPPES UpdateFebruary 6, 2013
✔ NPI 1396089660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in MN · LP4532
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4891 MILLER TRUNK HWY, Hermantown, MN 55811
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Other Providers at the Same Location NPPES 4

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

PAMELA J IDZIOREK RNNP
Nurse Practitioner
4891 MILLER TRUNK HWY
HERMANTOWN, MN 55811
St. Louis County (218) 626-1222
ANNE KATHERINE HENDRICKS
Nurse Practitioner (Psychiatric/Mental Health)
4891 MILLER TRUNK HWY
HERMANTOWN, MN 55811
St. Louis County (218) 306-8383
DR. ROBERT JAMES IDZIOREK JR. DDS
Dentist (General Practice)
4891 MILLER TRUNK HWY, SUITE 1
DULUTH, MN 55811
St. Louis County (218) 722-7770
DR. JEFFREY L OLSON PSYD LP
Psychologist (Clinical)
4891 MILLER TRUNK HWY, SUITE 106
HERMANTOWN, MN 55811
St. Louis County (218) 722-2525

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 Lake Superior Psychological Services, Inc.'s NPI number?

The NPI number for Lake Superior Psychological Services, Inc. is 1396089660. It was assigned to this organization in the NPPES registry on November 26, 2012.

Where is Lake Superior Psychological Services, Inc. located?

Lake Superior Psychological Services, Inc. is located at 4891 Miller Trunk Hwy Suite 106, Hermantown, MN 55811. The listed phone number is (218) 722-2525.

What is Lake Superior Psychological Services, Inc.'s specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Lake Superior Psychological Services, Inc. was last updated on February 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.