Healthcare Provider Details
I. General information
NPI: 1265992994
Provider Name (Legal Business Name): APOLLO COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2019
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7201 YORK AVE S APT 1220
EDINA MN
55435-4447
US
IV. Provider business mailing address
PO BOX 398161
EDINA MN
55439-8161
US
V. Phone/Fax
- Phone: 651-434-2166
- Fax:
- Phone: 651-434-2166
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SAMUEL
LAIS
MAJOR
Title or Position: OWNER
Credential: LMFT
Phone: 651-434-2166