MEDICARE: MANDY DON SCHLOESSER LPCC

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
1	101YP2500X	Professional Counselor	2505	MN

General Provider Information

NPI Number	:	1467077073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDY DON SCHLOESSER LPCC

Provider Business Mailing Address
First Line	:	2755 GRAND ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-2611
Country	:	US
Telephone Number	:	931-212-4108
Fax Number	:

Provider Business Practice Location Address
First Line	:	2755 GRAND ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-2611
Country	:	US
Telephone Number	:	931-212-4108
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	11/27/2023

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