Provider Demographics
NPI:1730252347
Name:EKHOLM, LORI (LMFT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:EKHOLM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2652
Mailing Address - Country:US
Mailing Address - Phone:612-245-2032
Mailing Address - Fax:651-925-0610
Practice Address - Street 1:7101 YORK AVE S STE 317
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4469
Practice Address - Country:US
Practice Address - Phone:763-703-4215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP58821OtherHEALTHPARTNERS
MN098162100Medicaid
MN599K4HOOtherBCBS
MN113354C154OtherUCARE