Organization
VAYDA MENTAL HEALTH COLLABORATIVE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISE MARIE NOVAK PSYD, LP (CO-FOUNDER)
(651) 240-2206
Entity
Organization
Contact information
Practice address
299 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-5869
(651) 240-2206
(612) 446-5766
Mailing address
13233 JOHNSON ST NE, BLAINE, MN 55434-4171
(612) 382-9781
(612) 446-5766
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
08/16/2020
Last updated
09/18/2020
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