Organization
LAKESIDE PSYCHOLOGY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE ANNE MCKAY PSY.D., LP (LICENSED CLINICAL PSYCHOLOGIST)
(612) 217-2719
Entity
Organization
Contact information
Practice address
4601 EXCELSIOR BLVD STE 340, ST LOUIS PARK, MN 55416-5228
(612) 217-2719
Mailing address
4601 EXCELSIOR BLVD STE 340, ST LOUIS PARK, MN 55416-5228
(612) 217-2719
(612) 208-8333
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629410139
—
MN
Enumeration date
08/28/2019
Last updated
10/04/2022
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