Provider Demographics
NPI:1811162746
Name:ADVANCED PRACTICE PSYC SERVICES, INC
Entity type:Organization
Organization Name:ADVANCED PRACTICE PSYC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:ANDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNS, MSN
Authorized Official - Phone:952-322-8532
Mailing Address - Street 1:11800 SINGLETREE LN STE 312
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5398
Mailing Address - Country:US
Mailing Address - Phone:952-322-8532
Mailing Address - Fax:952-322-8513
Practice Address - Street 1:11800 SINGLETREE LN STE 312
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-5398
Practice Address - Country:US
Practice Address - Phone:952-322-8532
Practice Address - Fax:952-322-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health