Healthcare Provider Details

I. General information

NPI: 1710693452
Provider Name (Legal Business Name): TAYLOR ELISE SAUGSTAD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 WAYZATA BLVD
ST LOUIS PARK MN
55426-1626
US

IV. Provider business mailing address

4100 BERKSHIRE LN N STE 250
PLYMOUTH MN
55446-3888
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 612-223-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5844
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: