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

Matthew E Ballenthin, PSYDLP

Individual provider Clinical Psychologist · NPI 1861745176

Matthew E Ballenthin, PSYDLP is a Clinical Psychologist in Lake Elmo, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
Specialties on file
2

Practice location Address checks out

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone: (651) 254-8580
Fax: (651) 254-0601
Show map & directions

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

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP5527 (MN)
Clinical Psychologist Taxonomy 103TC0700X · Licence LP5527 (MN)

Record details

NPI number1861745176
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYDLP
Sole proprietorNo
NPI enumeratedOctober 24, 2012
Last updated in NPPESMarch 9, 2021
Certification dateMarch 9, 2021
Mailing address8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

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