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Individual

MIKAYLA BAKER THORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, LADC

Contact information

Practice address
520 OSBORNE RD NE, FRIDLEY, MN 55432-2718
(763) 236-4569
Mailing address
3064 JANSEN AVE NE, SAINT MICHAEL, MN 55376-7520
(763) 236-4560

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
307010
MN
101YM0800X
Mental Health Counselor
Primary
5626
MN

Other

Enumeration date
06/02/2026
Last updated
06/02/2026
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