Healthcare Provider Details

I. General information

NPI: 1578260923
Provider Name (Legal Business Name): ELIZABETH ANN BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 MITCHELL RD
EDEN PRAIRIE MN
55344-1959
US

IV. Provider business mailing address

6531 BLUESTEM RD N
HAMEL MN
55340-4544
US

V. Phone/Fax

Practice location:
  • Phone: 612-924-3807
  • Fax:
Mailing address:
  • Phone: 612-834-1507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: