MEDICARE: SOVAK PSYCHOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1295693521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOVAK PSYCHOLOGY INC

Provider Business Mailing Address
First Line	:	9531 W 78TH ST STE 340
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-8001
Country	:	US
Telephone Number	:	612-314-6241
Fax Number	:	612-230-1235

Provider Business Practice Location Address
First Line	:	9531 W 78TH ST STE 340
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-8001
Country	:	US
Telephone Number	:	612-314-6241
Fax Number	:	612-230-1235

Authorized Official
Title or Position	:	OWNER/PSYCHOLOGIST
Name	:	DR. ANGELA FAYE SOVAK
Credential	:	PSYD LP
Telephone Number	:	612-314-6241

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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