Provider Demographics
NPI:1477098507
Name:ATTENTION & LEARNING SPECIALISTS
Entity Type:Organization
Organization Name:ATTENTION & LEARNING SPECIALISTS
Other - Org Name:PSYCHOLOGICAL ASSESSMENT SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LP
Authorized Official - Phone:612-799-6263
Mailing Address - Street 1:5775 WAYZATA BLVD, SUITE 700
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416
Mailing Address - Country:US
Mailing Address - Phone:612-799-6263
Mailing Address - Fax:888-827-5513
Practice Address - Street 1:5775 WAYZATA BLVD, SUITE 700
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-799-6263
Practice Address - Fax:888-827-5513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATTENTION & LEARNING SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-28
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
MNLP 1450251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1770832875Medicaid