Healthcare Provider Details

I. General information

NPI: 1356253843
Provider Name (Legal Business Name): NAVARASA PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WAYZATA BLVD E UNIT 1987
WAYZATA MN
55391-1951
US

IV. Provider business mailing address

1250 WAYZATA BLVD E UNIT 1987
WAYZATA MN
55391-1951
US

V. Phone/Fax

Practice location:
  • Phone: 612-418-2195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ANTHONY HAMILTON II
Title or Position: OWNER
Credential: PHD, LP
Phone: 612-418-2195