Lake Region Therapeutic Services Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LAKE REGION THERAPEUTIC SERVICES INC

Practice address

1007 Mainstreet
Hopkins, MN 55343-7517

Phone

(952) 456-6352

Fax

(952) 303-3104

NPI assigned

Feb 28, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abdirazaq Ibrahim

Title

Owner

Phone

(602) 323-4873

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1114484847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 OLD HIGHWAY 8 STE 347",
            "city": "SAINT ANTHONY",
            "state": "MN",
            "postal_code": "554182500",
            "telephone_number": "952-657-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MAINSTREET",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437517",
            "telephone_number": "952-456-6352",
            "fax_number": "952-303-3104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Bloomington Ave Apt 3",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071773",
            "country_code": "US",
            "telephone_number": "612-987-2990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE REGION THERAPEUTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ABDIRAZAQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-323-4873"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter L'Allier, D.C.
• Ladibugs LLC
• Trang T Lafitaga, NP
• Ruth Logue Lafortune, PHARMD
• Molly Jean Lahn, P.T.
• Lakeview Mental Health Partners Inc
• Allie Marie Lapenotiere, LPCC
• Libby Kathleen Larson Judy, D.C.
• Brianna Noelle Larson, M.S. CCC-SLP
• Katlyn Lastine

• Adult Mental Health Clinic/Center in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.