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General NPI Number Information
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NPI Number | 1902758071
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Entity Type | Organization
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Legal Business Name | NEURO ALLIES LLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 17715 KEYSTONE AVE
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City | LAKEVILLE
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State | MN
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Zip | 55044-9366
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Country | US
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Telephone | 612-308-7435
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Fax |
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Provider Business Mailing Address
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Address Line | 17715 KEYSTONE AVE
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City | LAKEVILLE
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State | MN
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Zip | 55044-9366
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Country | US
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Telephone | 612-308-7435
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST; OWNER
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Name | DR. LAURIE LYNN KINCADE
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Credential | PHD, LP, NCSP
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Telephone | 612-308-7435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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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