Healthcare Provider Details
I. General information
NPI: 1124838156
Provider Name (Legal Business Name): PRIORITY MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2025
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 1ST ST S STE 2B
WILLMAR MN
56201-4248
US
IV. Provider business mailing address
401 N 2ND ST UNIT 215
MINNEAPOLIS MN
55401-1582
US
V. Phone/Fax
- Phone: 612-643-0411
- Fax: 612-484-5957
- Phone: 612-219-8538
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELLEN
HONSA
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD, LP
Phone: 612-643-0411