Provider Demographics
NPI:1144311648
Name:MINGS, MARYANN (LPC)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:MINGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 200TH ST W
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-1170
Mailing Address - Country:US
Mailing Address - Phone:651-460-2933
Mailing Address - Fax:651-460-2933
Practice Address - Street 1:18598 ELK RIVER TRL STE 101
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-8679
Practice Address - Country:US
Practice Address - Phone:651-460-2933
Practice Address - Fax:651-460-2933
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00008101YP2500X
MO002504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional