Healthcare Provider Details

I. General information

NPI: 1831921220
Provider Name (Legal Business Name): ELEMENT PSYCHOTHERAPY AND COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 W 50TH ST STE 250-K
MINNEAPOLIS MN
55410-2047
US

IV. Provider business mailing address

6417 PENN AVE S STE 7-253
MINNEAPOLIS MN
55423-1186
US

V. Phone/Fax

Practice location:
  • Phone: 763-221-6821
  • Fax:
Mailing address:
  • Phone: 763-221-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KURT POPE
Title or Position: OWNER
Credential: LPCC
Phone: 763-221-6821