Healthcare Provider Details

I. General information

NPI: 1437014826
Provider Name (Legal Business Name): THERESA MARIE SANCHEZ LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 3RD AVE SE STE 202
ROCHESTER MN
55904-4632
US

IV. Provider business mailing address

3215 15TH AVE NW
ROCHESTER MN
55901-1467
US

V. Phone/Fax

Practice location:
  • Phone: 612-380-9779
  • Fax:
Mailing address:
  • Phone: 612-380-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number05329
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: