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NPI Code Detail

MEDICARE: DR. MARI ROBYN TANKENOFF LMHC, LPCC, LP

MEDICARE: DR. MARI ROBYN TANKENOFF LMHC, LPCC, LP
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
1101YP2500XProfessional CounselorLPCC0112771NM
2103TC1900XCounseling PsychologistLP3024MN
3101YM0800XMental Health CounselorLMHC009443NY
4101YM0800XMental Health CounselorLMHC255HI
5101YP2500XProfessional CounselorLPCC15619CA

General Provider Information

NPI Number : 1174719280
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARI ROBYN TANKENOFF LMHC, LPCC, LP
Provider Business Mailing Address
First Line : 621 W LAKE ST STE 350
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2952
Country : US
Telephone Number : 505-204-0569
Fax Number :
Provider Business Practice Location Address
First Line : 621 W LAKE ST STE 350
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2952
Country : US
Telephone Number : 612-979-2276
Fax Number : 651-925-0427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2007
Last Update Date : 10/22/2025

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