Provider Demographics
NPI:1164533212
Name:ORCHARD PSYCHOLOGISTS, PLLC
Entity Type:Organization
Organization Name:ORCHARD PSYCHOLOGISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:952-848-2297
Mailing Address - Street 1:6500 PARNELL AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1515
Mailing Address - Country:US
Mailing Address - Phone:952-848-2297
Mailing Address - Fax:952-929-6774
Practice Address - Street 1:7101 YORK AVE S
Practice Address - Street 2:SUITE 305
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4469
Practice Address - Country:US
Practice Address - Phone:952-848-2297
Practice Address - Fax:855-582-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4178103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN203T3OROtherBCBS