Healthcare Provider Details

I. General information

NPI: 1558549832
Provider Name (Legal Business Name): FAWN APRIL VOGT LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FAWN APRIL ROTH

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4284 DAHLBERG DR
GOLDEN VALLEY MN
55422-4805
US

IV. Provider business mailing address

4284 DAHLBERG DR
GOLDEN VALLEY MN
55422-4805
US

V. Phone/Fax

Practice location:
  • Phone: 952-428-6332
  • Fax: 952-562-2827
Mailing address:
  • Phone: 952-428-6332
  • Fax: 952-562-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC00373
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number301211
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: