Healthcare Provider Details

I. General information

NPI: 1942167705
Provider Name (Legal Business Name): SABRINA MAE ELLER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 METRO BLVD STE 425
EDINA MN
55439-3011
US

IV. Provider business mailing address

5995 OREN AVE N STE 203
OAK PARK HEIGHTS MN
55082-6379
US

V. Phone/Fax

Practice location:
  • Phone: 651-217-1480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5378
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: