Healthcare Provider Details

I. General information

NPI: 1336073600
Provider Name (Legal Business Name): CALLI SIMPSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7835 MAIN ST N STE 220
MAPLE GROVE MN
55369-7072
US

IV. Provider business mailing address

7835 MAIN ST N STE 220
MAPLE GROVE MN
55369-7072
US

V. Phone/Fax

Practice location:
  • Phone: 763-400-7475
  • Fax:
Mailing address:
  • Phone: 763-400-7475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4613
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: