Individual
ETHAN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
4201 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-4728
(952) 933-8900
Mailing address
4105 VERA CRUZ AVE N, MINNEAPOLIS, MN 55422-1724
(612) 444-1167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/11/2025
Last updated
11/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us