Provider Demographics
NPI:1144694407
Name:OPEN PATH THERAPY, LLC
Entity type:Organization
Organization Name:OPEN PATH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:651-315-4613
Mailing Address - Street 1:537 TUTTLE CT
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-8822
Mailing Address - Country:US
Mailing Address - Phone:651-315-4613
Mailing Address - Fax:
Practice Address - Street 1:4590 SCOTT TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3331
Practice Address - Country:US
Practice Address - Phone:612-548-1232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2829106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty