Provider Demographics
NPI:1003341801
Name:LASKI MENTAL WELLNESS & COUNSELING, LLC
Entity Type:Organization
Organization Name:LASKI MENTAL WELLNESS & COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:LASKI
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, MED, LICSW, L
Authorized Official - Phone:612-202-0535
Mailing Address - Street 1:2867 JAMES AVE S APT 4
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-1890
Mailing Address - Country:US
Mailing Address - Phone:612-202-0535
Mailing Address - Fax:612-224-9655
Practice Address - Street 1:7101 YORK AVE S STE 145
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4484
Practice Address - Country:US
Practice Address - Phone:612-202-0535
Practice Address - Fax:763-999-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-29
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN186221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty