Healthcare Provider Details

I. General information

NPI: 1134171127
Provider Name (Legal Business Name): CHOICES PSYCHOTHERAPY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 WAYZATA BLVD STE 100
MINNETONKA MN
55305-1500
US

IV. Provider business mailing address

10201 WAYZATA BLVD STE 100
MINNETONKA MN
55305-1500
US

V. Phone/Fax

Practice location:
  • Phone: 952-544-6806
  • Fax: 952-545-0098
Mailing address:
  • Phone: 952-544-6806
  • Fax: 952-545-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUSAN MARIE DAVIS
Title or Position: EXECUTIVE DIRECTOR
Credential: LICSW
Phone: 952-544-6806