Organization
NORTH PSYCHOLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE K. FELTON PH.D LP (PRESIDENT)
(763) 531-0566
Entity
Organization
Contact information
Practice address
11165 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 531-0566
(763) 531-0602
Mailing address
11165 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 531-0566
(763) 531-0602
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30786NO
BLUE CROSS BLUE SHIEL
MN
01
—
30787NO
BLUE CROSS BLUE SHIELD
MN
05
—
973518600
—
MN
Enumeration date
07/04/2006
Last updated
02/13/2025
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