Provider Demographics
NPI:1295003788
Name:FELLING, ELIZABETH ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:FELLING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:FELLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:348 PRIOR AVE N STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5188
Mailing Address - Country:US
Mailing Address - Phone:612-913-0413
Mailing Address - Fax:866-299-8807
Practice Address - Street 1:348 PRIOR AVE N STE 101
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-5188
Practice Address - Country:US
Practice Address - Phone:612-913-0413
Practice Address - Fax:866-299-8807
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist