Individual
ELLEN THERESE GORMICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3236 LONGFELLOW AVE, MINNEAPOLIS, MN 55407-3805
(612) 807-6872
Mailing address
3236 LONGFELLOW AVE, MINNEAPOLIS, MN 55407-3805
(612) 807-6872
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30671
MN
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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