Provider Demographics
NPI:1205822822
Name:RICHNOFSKY, LINDA M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:RICHNOFSKY
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 1:6451 255TH ST
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MN
Mailing Address - Zip Code:55092-9331
Mailing Address - Country:US
Mailing Address - Phone:651-464-5107
Mailing Address - Fax:
Practice Address - Street 1:220 RAILROAD ST SE
Practice Address - Street 2:THERAPEUTIC SERVICES AGENCY INC
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-1540
Practice Address - Country:US
Practice Address - Phone:320-629-7600
Practice Address - Fax:320-629-7900
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1192106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN489R7RIOtherBCBS
HP52395OtherHEALTH PARTNERS
MN867935500Medicare ID - Type Unspecified