LAKEVILLE BEHAVIORAL HEALTH, LLC (NPI# 1750412680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750412680 |
| Entity Type | Organization |
| Organization Name | LAKEVILLE BEHAVIORAL HEALTH, LLC |
| Practice Address |
10535 165th St W Lakeville MN 55044-5729 |
| Practice Telephone | 9524350022 |
| Practice Fax Number | 9524350095 |
| Mailing Telephone | 9524350022 |
| Mailing Fax Number | 9524350095 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-07-03 |
| Authorized Official Name | DALE KNUTE LOKKESMOE (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 9524350022 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP1249 | MN | Behavioral Health & Social Service Providers |
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP3587 | MN | Behavioral Health & Social Service Providers |
| Street Address |
10535 165TH ST W |
| City | LAKEVILLE |
| State | MN |
| Zip Code | 55044-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558437764 | Dale Knute Lokkesmoe | Psychologist | 10535 165th St W, Lakeville, MN 55044-5729 | 2006-11-28 |
| 1982238770 | Fairweather Investments, LLC | Counselor | 10535 165th St W, Lakeville, MN 55044-5729 | 2020-03-02 |
| 1851888739 | Aria E Seager | Marriage & Family Therapist | 10535 165th St W, Lakeville, MN 55044-5729 | 2018-04-17 |
| 1063950764 | Faye Wallus | Marriage & Family Therapist | 10535 165th St W, Lakeville, MN 55044-5729 | 2017-02-02 |
| 1700324324 | Catherine Burke | Marriage & Family Therapist | 10535 165th St W, Lakeville, MN 55044-5729 | 2017-02-02 |
| 1710354345 | David Nathan | Psychologist | 10535 165th St W, Lakeville, MN 55044-5729 | 2015-08-31 |
| 1679992267 | Katherine Sue Deregnier | Counselor | 10535 165th St W, Lakeville, MN 55044-5729 | 2014-04-10 |
| 1063750016 | Tracy Kotval | Counselor | 10535 165th St W, Lakeville, MN 55044-5729 | 2013-01-26 |
| 1073752952 | Michelle Marie Rude | Counselor | 10535 165th St W, Lakeville, MN 55044-5729 | 2009-02-17 |
| 1649338443 | Kevin P Kirley | Psychologist | 10535 165th St W, Lakeville, MN 55044-5729 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1164922373 | Invigorate Chiropractic, Pa | Chiropractor | 18449 Orchard Trail, Lakeville, MN 55044 | 2018-02-14 |
| 1275046344 | Kevin Schultz | Chiropractor | 18449 Orchard Tr, Lakeville, MN 55044 | 2017-11-13 |
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1275069676 | Alison Marie Weaver | Physical Therapist | 17599 Kenwood Trl Ste 200, Lakeville, MN 55044 | 2017-05-04 |
| 1184177479 | Megan Erickson | Physical Therapist | 21034 Heron Way Ste 102, Lakeville, MN 55044 | 2016-08-03 |
| 1669827523 | Kristine Louise Duhamel | Nurse Practitioner | 18275 Kenrick Avenue, Lakeville, MN 55044 | 2016-04-28 |
| 1003281536 | Heather Leann Wegner | Counselor | 16233 Kenyon Ave, Lakeville, MN 55044 | 2015-12-09 |
| 1982081295 | Dana Bungert | Specialist/Technologist | 11060 Upper 167th St W, Lakeville, MN 55044 | 2015-05-06 |
| 1265834931 | Kayla Schulz | Counselor | 7535 165th St West, Lakeville, MN 55044 | 2014-09-24 |
| Find all providers in zip 55044 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558437764 | Dale Knute Lokkesmoe | Psychologist | 10535 165th St W, Lakeville, MN 55044-5729 | 2006-11-28 |
| 1649338443 | Kevin P Kirley | Psychologist | 10535 165th St W, Lakeville, MN 55044-5729 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347854 | Shining Light Skill Building LLC | Psychologist | 3055 Old Highway 8 Ste 106b, St. Anthony, MN 55418 | 2020-08-17 |
| 1245750652 | Sara Vaccarella | Psychologist | 331 W Superior St Ste 300, Duluth, MN 55802-4532 | 2017-06-27 |
| 1780124305 | Families First Counseling Services LLC | Psychologist | 103 S Kingston St, Caledonia, MN 55921-1315 | 2017-03-01 |
| 1598150930 | Nova Bhs | Psychologist | 521 Tanglewood Dr., Shoreview, MN 55126 | 2015-04-02 |
| 1801208566 | Rose Mary Boerboom | Psychologist | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2014-05-28 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1992145288 | Rowan P Buckley | Psychologist | 6825 Owen St Ste 201, Loretto, MN 55357-9713 | 2013-07-01 |
| 1063781771 | Julie Ann Gomer | Psychologist | 13700 Reimer Dr N Ste 220, Maple Grove, MN 55311-4548 | 2011-12-26 |
| 1750697587 | Megan Horwitz Plumstead | Psychologist | 1619 Dayton Ave Ste 327, Saint Paul, MN 55104-6495 | 2010-08-31 |
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LAKEVILLE BEHAVIORAL HEALTH, 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.