OLITZKY PEDIATRIC PSYCHOLOGICAL SERVICES LLC (NPI# 1144604950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144604950 |
| Entity Type | Organization |
| Organization Name | OLITZKY PEDIATRIC PSYCHOLOGICAL SERVICES LLC |
| Practice Address |
4700 Park Glen Rd St Louis Park MN 55416-5701 |
| Mailing Address |
2516 Quentin Ct St Louis Park MN 55416-1900 |
| Practice Telephone | 9175757985 |
| Mailing Telephone | 9175757985 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |
| Authorized Official Name | DR. SARAH LITTMAN OLITZKY (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 9175757985 |
| Authorized Official Credential | PHD, LP, NCSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
LP5511 | MN | Behavioral Health & Social Service Providers |
| Street Address |
4700 PARK GLEN RD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-5701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073690145 | Michael D Hobbs | Pediatrics | 4700 Park Glen Rd, St Louis Park, MN 55416-5701 | 2006-11-01 |
| 1366674301 | Kirsten Rebekka Morse | Nurse Practitioner | 4700 Park Glen Rd, St Louis Park, MN 55416-5701 | 2009-08-09 |
| 1962553917 | Pediatric Services Pa | Clinic/Center | 4700 Park Glen Rd, St Louis Park, MN 55416-5701 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376524538 | Jordan Lynn Hart | Psychologist | 5353 Gamble Dr, Suite 110, St Louis Park, MN 55416-1509 | 2005-11-07 |
| 1134598667 | Jackie Engebretson | Psychologist | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2015-09-15 |
| 1720121254 | Sheila E Merzer | Psychologist | 4820 Minnetonka Blvd, Suite 200, St Louis Park, MN 55416-5707 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316405202 | Q Collective, LLC | Psychologist | 3413 Wilshire Pl Ne, Minneapolis, MN 55418-1447 | 2019-03-09 |
| 1043714199 | Julianna Sapienza | Psychologist | 2545 Chicago Ave Ste 217, Minneapolis, MN 55404-4556 | 2018-03-22 |
| 1942758701 | Dana Hoehn | Psychologist | 4636 Lyndale Ave S, Lower Unit, Minneapolis, MN 55419-5302 | 2016-09-21 |
| 1942687397 | Hope Psychology Practice, LLC | Psychologist | 2720 W. 43rd St., Suite 205, Minneapolis, MN 55410 | 2015-05-05 |
| 1861737041 | Decisionpoint Behavioral Health, Inc. | Psychologist | 206 S Broadway, Suite 411a, Rochester, MN 55904-6502 | 2012-11-29 |
| 1063725166 | Thomas Robert Lutz | Psychologist | 1125 Ramsey St, Hastings, MN 55033-2811 | 2010-07-17 |
| 1366755597 | Kristin L Ballard | Psychologist | 4005 W 65th St Ste 110, Edina, MN 55435-1700 | 2010-07-16 |
| 1316180011 | Brenda Diane Brant | Psychologist | 18473 97th Pl N, Maple Grove, MN 55311-1368 | 2009-04-09 |
| 1457554735 | Catherine Lawrence Scharlau | Psychologist | 1295 Bandana Blvd. North, Aspen Medical Group-behavioral Health, St. Paul, MN 55108 | 2007-06-06 |
| 1710196522 | Bill J Duke | Psychologist | 420 Center Ave Ste 7, Moorhead, MN 56560-1962 | 2007-05-21 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on OLITZKY PEDIATRIC PSYCHOLOGICAL SERVICES LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.