Healthcare Provider Details

I. General information

NPI: 1093619298
Provider Name (Legal Business Name): EMILY ELIZABETH VRCHOTA ENG MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E DIAMOND LAKE RD
MINNEAPOLIS MN
55419-1923
US

IV. Provider business mailing address

6 E DIAMOND LAKE RD
MINNEAPOLIS MN
55419-1923
US

V. Phone/Fax

Practice location:
  • Phone: 612-823-5178
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: