Healthcare Provider Details

I. General information

NPI: 1932285525
Provider Name (Legal Business Name): PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E 2ND ST OFFICE #1
REDWOOD FALLS MN
56283-1695
US

IV. Provider business mailing address

126 E 2ND ST OFFICE #1
REDWOOD FALLS MN
56283-1695
US

V. Phone/Fax

Practice location:
  • Phone: 507-627-1750
  • Fax: 507-627-1751
Mailing address:
  • Phone: 507-627-1750
  • Fax: 507-627-1751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP4330
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP4330
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP4330
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberLP4330
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberLP4330
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberLP4330
License Number StateMN
# 7
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberLP4330
License Number StateMN

VIII. Authorized Official

Name: DR. ANGELA PETERSON
Title or Position: PRESIDENT
Credential: PSYD,LP
Phone: 507-627-1750