Provider Demographics
NPI:1033661319
Name:TRNKA, AMANDA MORELAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MORELAN
Last Name:TRNKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:BETH
Other - Last Name:MORELAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:601 WARNER AVE S
Mailing Address - Street 2:
Mailing Address - City:MAHTOMEDI
Mailing Address - State:MN
Mailing Address - Zip Code:55115-6881
Mailing Address - Country:US
Mailing Address - Phone:651-485-2779
Mailing Address - Fax:651-405-0358
Practice Address - Street 1:760 STILLWATER RD STE 101
Practice Address - Street 2:
Practice Address - City:MAHTOMEDI
Practice Address - State:MN
Practice Address - Zip Code:55115-2060
Practice Address - Country:US
Practice Address - Phone:651-800-1189
Practice Address - Fax:651-705-8167
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
MN3288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist