Provider Demographics
NPI:1649780362
Name:MARGARET FLAGET-GREENER, PSYD LLC
Entity type:Organization
Organization Name:MARGARET FLAGET-GREENER, PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FLAGET-GREENER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-234-0722
Mailing Address - Street 1:9111 STANLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-2351
Mailing Address - Country:US
Mailing Address - Phone:610-675-4249
Mailing Address - Fax:
Practice Address - Street 1:5200 WILLSON RD STE 307
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55424-1344
Practice Address - Country:US
Practice Address - Phone:651-234-0722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-08
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1497195358Medicaid