Provider Demographics
NPI:1639875230
Name:MPEAK TEAM
Entity Type:Organization
Organization Name:MPEAK TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLI
Authorized Official - Middle Name:ALANNA BRAUN
Authorized Official - Last Name:KODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-272-9777
Mailing Address - Street 1:700 COMMERCE DR
Mailing Address - Street 2:STE 295
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9245
Mailing Address - Country:US
Mailing Address - Phone:651-272-9777
Mailing Address - Fax:
Practice Address - Street 1:700 COMMERCE DR
Practice Address - Street 2:STE 295
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9245
Practice Address - Country:US
Practice Address - Phone:651-272-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLI BRAUN KODY, PHD, LP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty