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General NPI Number Information
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NPI Number | 1184545253
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Entity Type | Individual
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Provider Name | SEAN MICHAEL MYHRE
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Gender | Male
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 3460 WASHINGTON DR STE 110
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City | EAGAN
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State | MN
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Zip | 55122-4301
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Country | US
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Telephone | 651-283-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 431 BETTY LN
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City | WEST ST PAUL
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State | MN
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Zip | 55118-2906
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Country | US
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Telephone | 651-283-6005
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 4952
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License Number State | MN
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