MEDICARE: AWELE ENEANYA 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1821616889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AWELE ENEANYA LPCC

Provider Business Mailing Address
First Line	:	708 N 1ST ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-1133
Country	:	US
Telephone Number	:	651-237-2391
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 N 1ST ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-1133
Country	:	US
Telephone Number	:	651-237-2391
Fax Number	:	612-446-5770

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

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	04/30/2026

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