OrganizationActive
Mental Health Resources
NPI 1891275582 · Addiction Psychiatry Physician · Spring Lake Park, MN
Provider details
- NPI number
- 1891275582
- Entity type
- Organization
- Primary specialty
- Addiction Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Roxanne Condon, Vp of Administrative Services(651) 659-2900
- License
- 30635 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7766 Highway 65 Ne
Spring Lake Park, MN 55432-2868
Phone: (763) 789-4895
Fax: (763) 789-4798
Approximate (ZIP-level) locationGet directions
Mailing address
762 Transfer Rd Ste 21
Saint Paul, MN 55114-1489
Other names (DBA / former)
- Doing business as
- Mhr
- Doing business as
- Mhr
Additional practice locations (2)
- 762 Transfer Rd Ste 21Saint Paul, MN 55114-1489Phone: (651) 659-2900Fax: (651) 645-7307
- 1650 Carroll AveSaint Paul, MN 55104-5227Phone: (763) 789-4895Fax: (763) 789-4798
Registry dates
- Enumerated
- 2018-08-21
- Last updated
- 2025-03-07
- Certified
- 2025-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.