Organization
CGC LLC
Active
Other names
Emerge Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH VOGT LP (CLINICAL PSYCHOLOGIST)
(612) 642-1754
Entity
Organization
Contact information
Practice address
4208 PARK GLEN RD, MINNEAPOLIS, MN 55416-4758
(630) 677-5437
Mailing address
4208 PARK GLEN RD, MINNEAPOLIS, MN 55416-4758
(630) 677-5437
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336374750
CLINICAL SOCIAL WORKER
MN
01
—
1447644224
SOCIAL WORKER CLINICAL
MN
Enumeration date
01/24/2019
Last updated
11/07/2024
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