Healthcare Provider Details

I. General information

NPI: 1952776346
Provider Name (Legal Business Name): TIMOTHY BATDORF LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 MITCHELL RD SUITE 100
EDEN PRAIRIE MN
55344-1959
US

IV. Provider business mailing address

7525 MITCHELL RD STE 100
EDEN PRAIRIE MN
55344-1900
US

V. Phone/Fax

Practice location:
  • Phone: 952-224-2282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4360
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: