Healthcare Provider Details

I. General information

NPI: 1518750181
Provider Name (Legal Business Name): AND STILL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 HIGHWAY 169 N STE 210
NEW HOPE MN
55428-4019
US

IV. Provider business mailing address

4900 HIGHWAY 169 N STE 210
NEW HOPE MN
55428-4019
US

V. Phone/Fax

Practice location:
  • Phone: 612-440-0841
  • Fax:
Mailing address:
  • Phone: 612-400-0831
  • 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: JOHANNA RAE ERICKSON
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: MA, LMFT
Phone: 612-440-0831