Act Psychological Services, PLLC
Organization Active NPI Community/Behavioral Health Agency · Saint Louis Park, MN
NPI 1407296288 · NPPES record last updated Jun 26, 2013
Key facts
- NPI
- 1407296288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- LP5358 (MN)
- Legal business name
- ACT PSYCHOLOGICAL SERVICES, PLLC
- Practice address
- 4601 Excelsior Blvd Ste 507a
Saint Louis Park, MN 55416-4977 - Phone
- (612) 836-3886
- NPI assigned
- Jun 26, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Kent David Smallwood, PH.D.
- Title
- Clinical Licensed Psychologist
- Phone
- (612) 836-3886
National Provider Directory
Locations
4601 Excelsior Blvd
Ste 507A
St Louis Park, MN 55416
Phone (612) 240-5174
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | LP5358 | MN | Yes |
Addresses
Primary practice location
4601 Excelsior Blvd Ste 507a
Saint Louis Park, MN 55416-4977
Mailing address
1028 Pike Lake Dr
New Brighton, MN 55112-2427
Phone (612) 836-3886
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- Shannon Jeanette Acuna
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All providers in Saint Louis Park, MN · Community/Behavioral Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.