Healthcare Provider Details

I. General information

NPI: 1477235281
Provider Name (Legal Business Name): LAUREN ANDERSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 S RIVER RIDGE CIR STE 200
BURNSVILLE MN
55337-1691
US

IV. Provider business mailing address

6929 MOCCASIN VALLEY RD
EDINA MN
55439-1630
US

V. Phone/Fax

Practice location:
  • Phone: 612-440-0507
  • Fax:
Mailing address:
  • Phone: 612-440-0507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4521
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: