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Organization

NORTHSTAR PSYCHOLOGY INC

Active
Parent organization
NORTHSTAR PSYCHOLOGY INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHSTAR PSYCHOLOGY INC.
Authorized official
NOVA BRADFORD (CEO)
(651) 500-1964
Entity
Organization

Contact information

Practice address
202 N CEDAR AVE # 1, OWATONNA, MN 55060-2306
(651) 500-1964
Mailing address
2108 N ST # 6487, SACRAMENTO, CA 95816-5712

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
104100000X
Social Worker
Primary
2084P0800X
Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
10/16/2023
Last updated
10/16/2023
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