Organization
TRANSFORMATIONAL PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN ILVEDSON MA, LPCC (PSYCHOTHERAPIST, OWNER)
(612) 710-3874
Entity
Organization
Contact information
Practice address
249 WATER ST RM 201, EXCELSIOR, MN 55331-1824
(612) 710-3874
Mailing address
5385 SHADY HILLS CIR, EXCELSIOR, MN 55331-9157
(612) 710-3874
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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