Provider Demographics
NPI:1194820225
Name:TSCHIDA, STEPHANIE L (LMFT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:TSCHIDA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 BIELENBERG DR STE 125
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4426
Mailing Address - Country:US
Mailing Address - Phone:651-829-6608
Mailing Address - Fax:651-739-1998
Practice Address - Street 1:7650 CURRELL BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-286-8560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN592277100Medicaid