Organization
Mental Health Resources
Provider's NPPES record last updated: March 7, 2025
Overview
- Entity Type
- Organization
- NPI
- 1891275582
- Primary Specialty
- Psychiatry & Neurology — Addiction Psychiatry
- Practice Location
- Spring Lake Park, Minnesota
- Organization Subpart
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 17, 2026, 10:59 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Psychiatry & Neurology
Addiction Psychiatry
Allopathic & Osteopathic Physicians
Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Taxonomy code 2084P0802X
Provider-Reported License Information
- Psychiatry & Neurology (Minnesota)
- 30635
Practice Locations
Practice Location
7766 Highway 65 Ne
Spring Lake Park, Minnesota 55432-2868
Phone: (763) 789-4895
Additional Practice Location
1650 Carroll Ave
Saint Paul, Minnesota 55104-5227
Phone: (763) 789-4895
Fax: (763) 789-4798
Additional Practice Location
762 Transfer Rd Ste 21
Saint Paul, Minnesota 55114-1489
Phone: (651) 659-2900
Fax: (651) 645-7307
Other Names
- MhrReported August 20, 2018
- MhrReported August 21, 2018
Record Information
- Enumeration Date
- August 21, 2018
- Provider's NPPES Record Last Updated
- March 7, 2025
- Certification Date
- March 7, 2025
- NPISignal NPPES Dataset
- August 2026
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