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General NPI Number Information
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NPI Number | 1922911718
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Entity Type | Organization
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Legal Business Name | EXPANSIVE RELATIONS THERAPY PLLC
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 6 E 45TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-5026
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Country | US
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Telephone | 507-366-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 METRO BLVD STE 550
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City | EDINA
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State | MN
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Zip | 55439-1353
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Country | US
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Telephone | 507-366-8963
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MAYA SEVERSON-MCCORMICK
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Credential | LMFT
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Telephone | 320-491-8773
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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 |
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License Number State |
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