Provider Demographics
NPI:1467975607
Name:MESM, LLC
Entity Type:Organization
Organization Name:MESM, LLC
Other - Org Name:MARGOT STORTI-MARRON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:
Authorized Official - Last Name:STORTI-MARRON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:763-400-7077
Mailing Address - Street 1:16460 78TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311
Mailing Address - Country:US
Mailing Address - Phone:763-416-6350
Mailing Address - Fax:
Practice Address - Street 1:11224 86TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4510
Practice Address - Country:US
Practice Address - Phone:763-400-7077
Practice Address - Fax:763-400-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN068841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528159860OtherNPI