Healthcare Provider Details

I. General information

NPI: 1346155959
Provider Name (Legal Business Name): CHRISTOFILI ATHANASIOS COOP LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTOFILI ATHANASIOS CHRONAKOS LPCC, LADC

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 UNIVERSITY AVE W STE 435S
SAINT PAUL MN
55114-1907
US

IV. Provider business mailing address

2550 UNIVERSITY AVE W STE 435S
SAINT PAUL MN
55114-1907
US

V. Phone/Fax

Practice location:
  • Phone: 651-647-1900
  • Fax: 651-342-8023
Mailing address:
  • Phone: 651-647-1900
  • Fax: 651-342-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306941
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5784
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: