Healthcare Provider Details

I. General information

NPI: 1760397269
Provider Name (Legal Business Name): MN NEURODIVERSE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 8TH AVE S
HOPKINS MN
55343-7613
US

IV. Provider business mailing address

51 8TH AVE S
HOPKINS MN
55343-7613
US

V. Phone/Fax

Practice location:
  • Phone: 412-877-4707
  • Fax:
Mailing address:
  • Phone: 412-877-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ZANE ROSEN
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC LADC
Phone: 412-877-4707