# CHILD AND FAMILY SPECIALTY CLINIC P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376765529
- **Authorized official:** JEANNE ELLEN GILFIX (CFO)
- **Authorized official phone:** (612) 821-1920

## Contact information

- **Practice address:** 4748 CHICAGO AVE STE 1, MINNEAPOLIS, MN 55407-4311
- **Practice address phone:** (612) 821-1920
- **Practice address fax:** (612) 821-1919
- **Mailing address:** 4748 CHICAGO AVE STE 1, MINNEAPOLIS, MN 55407-4311
- **Mailing address phone:** (952) 250-6948
- **Mailing address fax:** (612) 821-1919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 00215 | MN | Yes |
| 1041C0700X | Clinical Social Worker | 15301 | MN | — |
| 1041C0700X | Clinical Social Worker | 9839 | MN | — |
| 106H00000X | Marriage & Family Therapist | 1075 | MN | — |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 05/22/2026