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General NPI Number Information
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NPI Number | 1023858610
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Entity Type | Individual
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Provider Name | ELIZABETH POWELL LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 79 13TH AVE NE STE 103B
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-1071
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Country | US
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Telephone | 218-429-5434
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 COUNTY ROAD 42 W STE 309
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City | BURNSVILLE
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State | MN
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Zip | 55306-6213
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Country | US
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Telephone | 763-607-4038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4201
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License Number State | MN
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