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General NPI Number Information
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NPI Number | 1558768895
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Entity Type | Organization
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Legal Business Name | CARDINAL PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 7250 HUDSON BLVD N STE 205
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City | OAKDALE
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State | MN
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Zip | 55128-7162
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Country | US
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Telephone | 651-447-3605
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Fax | 651-634-1435
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Provider Business Mailing Address
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Address Line | 7250 HUDSON BLVD N STE 205
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City | OAKDALE
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State | MN
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Zip | 55128-7162
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Country | US
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Telephone | 651-447-3605
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Fax | 651-634-1435
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Authorized Official
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Title or Position | OWNER, LPCC
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Name | ANDREA ALESCHA SCHARLATT
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Credential |
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Telephone | 651-304-6047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC01220
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License Number State | MN
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