MEDICARE: ALLISON LOUISE QUAST LPCC

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	101YP2500X	Professional Counselor	CC00483	MN

General Provider Information

NPI Number	:	1083976674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON LOUISE QUAST LPCC

Provider Business Mailing Address
First Line	:	7600 PARKLAWN AVE STE 380
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-5156
Country	:	US
Telephone Number	:	612-203-2961
Fax Number	:	952-831-0033

Provider Business Practice Location Address
First Line	:	7600 PARKLAWN AVE STE 380
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435
Country	:	US
Telephone Number	:	612-203-2961
Fax Number	:	952-831-0033

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2012
Last Update Date	:	07/21/2022

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Directions to “ ALLISON LOUISE QUAST LPCC” Practice Location

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