Organization
NORTHERN LIGHTS PSYCHOLOGICAL SERVICES P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA A KENNEDY PSY.D., L.P. (CEO)
(507) 828-1433
Entity
Organization
Contact information
Practice address
1010 FRONTIER DR, SUITE 104, FERGUS FALLS, MN 56537-1023
(507) 828-1433
Mailing address
PO BOX 3, UNDERWOOD, MN 56586-0003
(507) 828-1433
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LP4330
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589175200
—
MN
01
—
6178609
MEDICA
MN
01
—
978T6PS
BCBS OF MN
—
Enumeration date
10/14/2012
Last updated
10/14/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up