Healthcare Provider Details

I. General information

NPI: 1801733209
Provider Name (Legal Business Name): BAYLEE VAN WINKLE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BAYLEE POLZIN PSYD

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

3914 VALLEY VIEW DR N APT 105
EAGAN MN
55122-1534
US

V. Phone/Fax

Practice location:
  • Phone: 406-579-3077
  • Fax:
Mailing address:
  • Phone: 406-579-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6032
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: