MEDICARE: YOUTH AND FAMILY CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP2536	MN

General Provider Information

NPI Number	:	1073694956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH AND FAMILY CENTER INC

Provider Business Mailing Address
First Line	:	4405 E LAKE ST
Second Line	:
City	:	MPLS
State	:	MN
Zip	:	55406
Country	:	US
Telephone Number	:	612-722-9612
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 E LAKE ST
Second Line	:
City	:	MPLS
State	:	MN
Zip	:	55406
Country	:	US
Telephone Number	:	612-722-9612
Fax Number	:

Authorized Official
Title or Position	:	CO CEO
Name	:	MARTHA JANE MERRIMAN
Credential	:	MA LP
Telephone Number	:	612-722-9612

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1770887424 — EAST BOUND AND DOWN REHAB PLLC
Practice Location Address:

2703 E LAKE ST.
MPLS, MN
55406

Practice Phone: 612-597-1371
Practice Fax: 763-545-8254

1609837301 — EILEEN ANN KERR PA-C
Practice Location Address:

2700 E LAKE ST , #1100
MINNEAPOLIS, MN
55406-1963

Practice Phone: 612-873-8100
Practice Fax: 612-276-0177

1558446161 — MS. MARCIA J KRANZ LAC MA AC NCCAOM
Practice Location Address:

115 FIFTH ST EAST
HASTINGS, MN
55033

Practice Phone: 651-480-8244
Practice Fax:

1831261510 — FAMILY DENTAL CARE OF S MPLS PA
Practice Location Address:

3152 MINNEHAHA AVE
MINNEAPOLIS, MN
55406-2774

Practice Phone: 612-728-8888
Practice Fax: 612-724-2737

1366442055 — MS. THRACE A. SORYN M.A., L.P.
Practice Location Address:

2124 DUPONT AVE. SO. , SUITE G1
MPLS, MN
55405

Practice Phone: 612-374-2194
Practice Fax:

1649248550 — MARY LOUISE WISE PH.D., L.P.
Practice Location Address:

2 E. FRANKLIN AVE. , #6
MPLS, MN
55403

Practice Phone: 952-451-8199
Practice Fax:

Directions to “YOUTH AND FAMILY CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.