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General NPI Number Information
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NPI Number | 1881575207
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Entity Type | Organization
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Legal Business Name | LISTUG-LUNDE PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 600 25TH AVE S STE 209
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4866
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Country | US
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Telephone | 320-448-8545
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Fax |
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Provider Business Mailing Address
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Address Line | 600 25TH AVE S STE 209
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4866
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Country | US
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Telephone | 320-448-8545
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI LISTUG-LUNDE
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Credential | LP
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Telephone | 320-448-8545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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