Provider Demographics
NPI:1437422441
Name:SCHEELER-HENNEN, MARYANN GERALDINE (MS, LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:GERALDINE
Last Name:SCHEELER-HENNEN
Suffix:
Gender:F
Credentials:MS, LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N PINE ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1886
Mailing Address - Country:US
Mailing Address - Phone:952-228-5073
Mailing Address - Fax:952-516-5983
Practice Address - Street 1:500 N PINE ST STE 201B
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1886
Practice Address - Country:US
Practice Address - Phone:952-228-5073
Practice Address - Fax:952-516-5983
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00425101YP2500X
MN2191106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional