Organization
CHARLENE PORTNOY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE MAYSON PORTNOY MSW (LICSW, LMFT)
(612) 760-2859
Entity
Organization
Contact information
Practice address
6465 WAYZATA BLVD STE 355, ST LOUIS PARK, MN 55426-1730
(612) 760-2859
(612) 926-8915
Mailing address
6465 WAYZATA BLVD STE 355, ST LOUIS PARK, MN 55426-1730
(612) 760-2859
(612) 926-8915
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01769
MN
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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