Provider Demographics
NPI:1467220939
Name:MILTON, TANIA (LPCC)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:MILTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 UNIVERSITY AVE NE STE 160
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3127
Mailing Address - Country:US
Mailing Address - Phone:612-254-0500
Mailing Address - Fax:612-234-4788
Practice Address - Street 1:7260 UNIVERSITY AVE NE STE 160
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55432-3127
Practice Address - Country:US
Practice Address - Phone:612-254-0500
Practice Address - Fax:612-234-4788
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health