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NPI Code Detail

MEDICARE: MS. SHEILA KATHRYN ANDERSON LMFT

MEDICARE: MS. SHEILA KATHRYN ANDERSON LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist2231MN

General Provider Information

NPI Number : 1154769164
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHEILA KATHRYN ANDERSON LMFT
Provider Business Mailing Address
First Line : 17645 JUNIPER PATH STE 105
Second Line :
City : LAKEVILLE
State : MN
Zip : 55044-7491
Country : US
Telephone Number : 952-600-8191
Fax Number : 952-600-8044
Provider Business Practice Location Address
First Line : 17645 JUNIPER PATH STE 105
Second Line :
City : LAKEVILLE
State : MN
Zip : 55044-7491
Country : US
Telephone Number : 952-600-8191
Fax Number : 952-600-8044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2013
Last Update Date : 11/15/2024

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