MEDICARE: CRSFALZONE LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790659175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRSFALZONE LLC

Provider Business Mailing Address
First Line	:	6600 HILLSIDE LN
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55439-1318
Country	:	US
Telephone Number	:	952-378-0398
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 E 40TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3186
Country	:	US
Telephone Number	:	952-378-0398
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	CARLY RAE SPOTTS-FALZONE
Credential	:	LPCC
Telephone Number	:	952-378-0398

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	10/22/2025

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Directions to “CRSFALZONE LLC ” Practice Location

Language	Start Address	Practice Location

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