Lakeside Psychological Services

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

LAKESIDE PSYCHOLOGICAL SERVICES

Practice address

2618 Emerald Dr
Grand Rapids, MN 55744-5060

Phone

(218) 327-9013

Fax

(218) 327-9013

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Coreen Ellen Lauseng

Title

Billing Agent

Phone

(952) 935-1961

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn Grieve, LPMED

  • Counseling Psychologist
  • Grand Rapids, MN
  • NPI 1396840955
  NPD (past)
• Richard Puckett, LPMED

  • Counseling Psychologist
  • Grand Rapids, MN
  • NPI 1639275761
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316043458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 EMERALD DR",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557445060",
            "telephone_number": "218-327-9013",
            "fax_number": "218-327-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 EMERALD DR",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557445060",
            "telephone_number": "218-327-9013",
            "fax_number": "218-327-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAUSENG",
        "authorized_official_first_name": "COREEN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "952-935-1961"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "8G811GR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Stuart Kuehn, DDS
• Erika M Kuehn, D.O.
• Matthew Kustritz
• Joseph William Lackner, PA-C
• Steven F. Lader, DO
• Lakeview Behavioral Health Inc.
• Lakeview Behavioral Health LLC
• Lauren Richard Lampi, D. D. S.
• Tori Lynn Lange, LPCC
• Brittney Ann Larsen, BS, LADC

• Counseling Psychologist in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.