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General NPI Number Information
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NPI Number | 1801091749
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Entity Type | Individual
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Provider Name | LAURA JANELLE MCDERMOTT PMHNP-BC, CNP, LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 6452 CITY WEST PKWY
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3245
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Country | US
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Telephone | 952-999-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 5624 LINCOLN DR STE 295
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City | EDINA
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State | MN
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Zip | 55436-1606
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Country | US
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Telephone | 612-987-8022
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Fax | 612-465-1788
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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 | 001175
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2619
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12047
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License Number State | MN
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