Individual
EMILY COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS, LPCC, LADC
Contact information
Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(651) 964-2490
Mailing address
4641 PORTLAND AVE, MINNEAPOLIS, MN 55407-3551
(770) 298-3582
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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