Healthcare Provider Details

I. General information

NPI: 1912892936
Provider Name (Legal Business Name): KATHERINE HARRELL PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 E LAKE ST STE 206B
MINNEAPOLIS MN
55406-1928
US

IV. Provider business mailing address

2708 E LAKE ST STE 206B
MINNEAPOLIS MN
55406-1928
US

V. Phone/Fax

Practice location:
  • Phone: 612-888-6951
  • Fax:
Mailing address:
  • Phone: 612-888-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHERINE ALICE HARRELL
Title or Position: OWNER
Credential: LMFT
Phone: 214-683-7035