Healthcare Provider Details

I. General information

NPI: 1932851599
Provider Name (Legal Business Name): EMILY HALLAHAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2772 IVY AVE NE
SAINT MICHAEL MN
55376-2029
US

IV. Provider business mailing address

2772 IVY AVE NE
SAINT MICHAEL MN
55376-2029
US

V. Phone/Fax

Practice location:
  • Phone: 267-895-0673
  • Fax:
Mailing address:
  • Phone: 267-895-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: