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General NPI Number Information
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NPI Number | 1740155886
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Entity Type | Organization
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Legal Business Name | FROM MY SIDE OF THE COUCH LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 9890 42ND ST NE
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City | SAINT MICHAEL
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State | MN
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Zip | 55376-3020
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Country | US
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Telephone | 321-458-5663
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Fax | 763-355-9169
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Provider Business Mailing Address
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Address Line | 9890 42ND ST NE
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City | SAINT MICHAEL
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State | MN
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Zip | 55376-3020
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Country | US
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Telephone | 321-458-5663
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Fax | 763-355-9169
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JESSICA ELIZABETH KATZ
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Credential | MS, LCMHC, LMHC, LPC
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Telephone | 321-458-5663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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