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Individual

CHERLEIGH CARPENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EDD, LICSW, LADC, MH

Contact information

Practice address
3333 N 4TH ST, MINNEAPOLIS, MN 55412-2615
(612) 767-8671
(612) 827-1215
Mailing address
5500 NICOLLET AVE UNIT 19321, MINNEAPOLIS, MN 55419-1991
(612) 767-8671
(612) 827-1215

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
307009
MN
101YM0800X
Mental Health Counselor
MN
101YM0800X
Mental Health Counselor
Primary
103TC2200X
Clinical Child & Adolescent Psychologist
390200000X
MN
1041C0700X
Clinical Social Worker
Primary
27427
MN
390200000X
Student in an Organized Health Care Education/Training Program
SEE-103TC2200X
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1558800136
NPI
MN
Enumeration date
02/16/2017
Last updated
02/19/2026
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