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WATERSHED PSYCHOLOGICAL SERVICES
NPI 1952763351
Clinic/Center - Mental Health (Including Community Mental Health Center) in Blaine, MN

Active since March 24, 2016
4255 PHEASANT RIDGE DRIVE, SUITE 412, BLAINE, MN 55391(763) 317-6222(763) 307-3835 Get Directions Write a Review

NPPES record last updated: August 8, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 8, 2016, Mar 24, 2016 (2 updates tracked since 2016).

About Watershed Psychological Services NPPES

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

WATERSHED PSYCHOLOGICAL SERVICES (NPI 1952763351) is a healthcare organization registered as a mental health (including community mental health center) in Blaine, Minnesota and active in the NPI registry since March 2016. The organization lists Megan Jean Boom Shedlock, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1952763351
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameWATERSHED PSYCHOLOGICAL SERVICES
Location Address4255 PHEASANT RIDGE DRIVE, SUITE 412Blaine, MN 55391
Mailing Address4255 Pheasant Ridge Dr Ne, Suite 412Blaine, MN 55449-4537 · (763) 317-6222 · Fax (763) 307-3835
Phone(763) 317-6222
Fax(763) 307-3835
Organization SubpartNo
Authorized OfficialMegan Jean Boom ShedlockCo-owner · (320) 266-4535
Enumeration DateMarch 24, 2016
Last NPPES UpdateAugust 8, 20162 updates tracked since enumeration
✔ NPI 1952763351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
4255 PHEASANT RIDGE DRIVE, Blaine, MN 55391
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

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 Watershed Psychological Services's NPI number?

The NPI number for Watershed Psychological Services is 1952763351. It was assigned to this organization in the NPPES registry on March 24, 2016.

Where is Watershed Psychological Services located?

Watershed Psychological Services is located at 4255 Pheasant Ridge Drive Suite 412, Blaine, MN 55391. The listed phone number is (763) 317-6222.

What is Watershed Psychological Services's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

What insurance does Watershed Psychological Services accept?

Health plans from HealthPartners list Watershed Psychological Services as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Watershed Psychological Services was last updated on August 8, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.