MEDICARE: HEATHER SVOBODA MA LP

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	103TC1900X	Counseling Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LP5110	OTHER	MN	BOARD OF PSYCHOLOGY
2	1629214747	OTHER		NPPES (NPI)

General Provider Information

NPI Number	:	1760371611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEATHER SVOBODA MA LP

Provider Business Mailing Address
First Line	:	1900 HENNEPIN AVE STE 205
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3160
Country	:	US
Telephone Number	:	651-300-6266
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 HENNEPIN AVE STE 205
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3189
Country	:	US
Telephone Number	:	651-300-6266
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	HEATHER L SVOBODA
Credential	:	MA LP
Telephone Number	:	651-300-6266

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	05/28/2026

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Directions to “HEATHER SVOBODA MA LP ” Practice Location

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