Organization
INNOVATIVE PSYCHOLOGICAL CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN TODD ANDERSON PSY.D. (CEO)
(763) 416-4167
Entity
Organization
Contact information
Practice address
7372 KIRKWOOD CT, MAPLE GROVE, MN 55369-5202
(763) 416-4167
(763) 416-4137
Mailing address
7372 KIRKWOOD CT, MAPLE GROVE, MN 55369-5202
(763) 416-4167
(763) 416-4137
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
LP4615
MN
103TC1900X
Counseling Psychologist
LP4615
MN
Other
Enumeration date
07/22/2006
Last updated
09/11/2025
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