Healthcare Provider Details

I. General information

NPI: 1417322025
Provider Name (Legal Business Name): LEVAN COUNSELING & CONSULTING SERVICES PROFESSIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8525 EDINBROOK XING STE 2
BROOKLYN PARK MN
55443-1970
US

IV. Provider business mailing address

2079 128TH LN NW
MINNEAPOLIS MN
55448-2521
US

V. Phone/Fax

Practice location:
  • Phone: 612-200-2053
  • Fax: 612-234-4788
Mailing address:
  • Phone: 612-200-2053
  • Fax: 612-234-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIKA MCAFEE-LEVAN
Title or Position: FOUNDER
Credential: LPCC
Phone: 612-200-2053