Provider Demographics
NPI:1245610856
Name:AFFINITY PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:AFFINITY PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERIDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:612-564-5865
Mailing Address - Street 1:7401 METRO BLVD STE 525
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3059
Mailing Address - Country:US
Mailing Address - Phone:612-268-5858
Mailing Address - Fax:612-268-5868
Practice Address - Street 1:7401 METRO BLVD STE 525
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439
Practice Address - Country:US
Practice Address - Phone:612-268-5858
Practice Address - Fax:612-268-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 5842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty