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General NPI Number Information
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NPI Number | 1447061049
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Entity Type | Organization
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Legal Business Name | AWARE THERAPY
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1704 N RIVERFRONT DR STE 105
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City | MANKATO
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State | MN
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Zip | 56001-3284
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Country | US
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Telephone | 651-503-3437
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Fax | 507-345-2022
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Provider Business Mailing Address
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Address Line | 1704 N RIVERFRONT DR STE 105
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City | MANKATO
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State | MN
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Zip | 56001-3284
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Country | US
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Telephone | 651-503-3437
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Fax | 507-345-2022
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ELIZBETH DENISE MCKAY
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Credential | LICSW
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Telephone | 651-503-3437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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