Healthcare Provider Details

I. General information

NPI: 1255258786
Provider Name (Legal Business Name): SOPHIE LYNN POYNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 MONTREAL AVE STE 107
SAINT PAUL MN
55116-2393
US

IV. Provider business mailing address

1150 MONTREAL AVE STE 107
SAINT PAUL MN
55116-2393
US

V. Phone/Fax

Practice location:
  • Phone: 651-313-8080
  • Fax: 651-925-0610
Mailing address:
  • Phone: 651-313-8080
  • Fax: 651-925-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: