Parkside Psychology, Inc.
NPI 1114175791ActiveOrganization· Psychologist, Clinical· Minneapolis, MN
Psychologist, Clinical in Minneapolis, Minnesota, registered in NPPES in September 2008. The authorized official on file is Sally Ruth Moore, PSY. D, Psychologist/Owner.
Overview
| NPI | 1114175791 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 8, 2008 |
| Last updated in NPPES | Sep 8, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP1891 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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