Organization
PRISMATIC PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL SEVERNS GUNTZEL LPCC (OWNER)
(612) 440-8931
Entity
Organization
Contact information
Practice address
4801 1/2 NICOLLET AVE, MINNEAPOLIS, MN 55419-5510
(612) 440-8931
Mailing address
4144 21ST AVE S, MINNEAPOLIS, MN 55407-3074
(612) 978-3321
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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