Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maple Psychiatry

Organization Psychiatry Physician · NPI 1194593566

Maple Psychiatry is a Psychiatry Physician in Roseville, Minnesota. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2

Practice location Address checks out

1873 Shryer Ave W
Roseville, MN 55113-5413
Phone: (425) 446-0012
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Child & Adolescent Psychiatry Physician (primary) Taxonomy 2084P0804X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1194593566
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicole Burkette Ikebata — Psychiatrist · (425) 446-0012
NPI enumeratedDecember 15, 2023
Last updated in NPPESDecember 15, 2023
Certification dateDecember 15, 2023
Mailing address202 N Cedar Ave Ste 1, Owatonna, MN 55060-2306

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