Individual
LISA D MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2626 E 82ND ST STE 335, BLOOMINGTON, MN 55425-1682
(651) 263-4149
Mailing address
3335 BUCHANAN ST NE, MINNEAPOLIS, MN 55418-1449
(651) 263-4149
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CC04077
MN
101YM0800X
Mental Health Counselor
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
MN
Other
Enumeration date
03/24/2022
Last updated
08/06/2025
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