1790278679 NPI number — MRS. ELIZABETH BIGLOW ANDERSON LMFT

Table of content: MRS. ELIZABETH BIGLOW ANDERSON LMFT (NPI 1790278679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790278679 NPI number — MRS. ELIZABETH BIGLOW ANDERSON LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
ELIZABETH
Provider Middle Name:
BIGLOW
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790278679
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 10TH AVE S, BIRCH COUNSELING, LLC
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
HOPKINS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55343-9481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-710-9091
Provider Business Mailing Address Fax Number:
763-717-8049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4150 OLSON MEMORIAL HWY, BIRCH COUNSELING, LCC
Provider Second Line Business Practice Location Address:
SUITE 420
Provider Business Practice Location Address City Name:
GOLDEN VALLY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55422-4823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-710-9091
Provider Business Practice Location Address Fax Number:
763-717-8049
Provider Enumeration Date:
06/14/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)