OrganizationActive
Act Psychological Services, PLLC
NPI 1407296288 · Community/Behavioral Health Agency · Saint Louis Park, MN
Provider details
- NPI number
- 1407296288
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Authorized official
- Kent Smallwood, Clinical Licensed Psychologist
- License
- LP5358 (MN)
Practice location
4601 Excelsior Blvd Ste 507a
Saint Louis Park, MN 55416-4977
Phone: (612) 836-3886
Mailing address
1028 Pike Lake Dr
New Brighton, MN 55112-2427
Registry dates
- Enumerated
- 2013-06-26
- Last updated
- 2013-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.