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BOURDEAUX PSYCHOLOGICAL SERVICES
NPI 1689034910
Psychologist - Clinical in Stacy, MN

Active since February 29, 2016
4425 311TH ST, STACY, MN 55079(612) 326-0775(161) 243-5411 Get Directions Write a Review

NPPES record last updated: February 29, 2016. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Bourdeaux Psychological Services NPPES

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

BOURDEAUX PSYCHOLOGICAL SERVICES (NPI 1689034910) is a healthcare organization registered as a clinical in Stacy, Minnesota and active in the NPI registry since February 2016. The organization lists Monique Marie Bourdeaux-colburn, Licensed Psychologist, as its authorized official.

NPPES Registry Identity

NPI1689034910
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameBOURDEAUX PSYCHOLOGICAL SERVICES
Location Address4425 311TH STStacy, MN 55079-9299
Mailing Address4425 311th StStacy, MN 55079-9299 · (612) 326-0775 · Fax (161) 243-5411
Phone(612) 326-0775
Fax(161) 243-5411
Organization SubpartNo
Authorized OfficialMonique Marie Bourdeaux-colburnLicensed Psychologist · (612) 326-0775
Enumeration DateFebruary 29, 2016
✔ NPI 1689034910 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 · LP5690
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.
4425 311TH ST, Stacy, MN 55079
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Bourdeaux Psychological Services's NPI number?

The NPI number for Bourdeaux Psychological Services is 1689034910. It was assigned to this organization in the NPPES registry on February 29, 2016.

Where is Bourdeaux Psychological Services located?

Bourdeaux Psychological Services is located at 4425 311th St, Stacy, MN 55079. The listed phone number is (612) 326-0775.

What is Bourdeaux Psychological Services'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 Bourdeaux Psychological Services was last updated on February 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.