# NORTHEAST ART THERAPY LLC

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

## Provider details

- **NPI number:** 1639631708
- **Authorized official:** AUDEN O'CONNELL LPCC (OWNER)
- **Authorized official phone:** (512) 509-9987

## Contact information

- **Practice address:** 79 13TH AVE NE STE 103A, MINNEAPOLIS, MN 55413-1073
- **Practice address phone:** (612) 509-9987
- **Practice address fax:** (612) 421-0036
- **Mailing address:** 79 13TH AVE NE STE 103A, MINNEAPOLIS, MN 55413-1073
- **Mailing address phone:** (612) 509-9987
- **Mailing address fax:** (612) 421-0036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2019
- **Last updated:** 04/05/2019