Northeast Psychotherapy
Counselor in Minneapolis, MN. Organization (NPI-2).
NPI number1336799154
StatusActive
Last updated in NPPESMar 13, 2020
Details
- NPI
- 1336799154
- Entity type
- Organization (NPI-2)
- Legal business name
- Northeast Psychotherapy
- Organization subpart
- No
- Enumeration date
- Sep 13, 2019
- Certification date
- Mar 13, 2020
- Last updated
- Mar 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
1224 2nd St Ne # 200Minneapolis, MN 55413-1130
Phone 612-408-5004
Mailing address
1300 Pierce Ter NeColumbia Heights, MN 55421-1845
Phone 612-408-5004
Authorized official
Cody Lewis Oaks
Psychotherapist/Owner
6124085004
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