Provider Demographics
NPI:1508391863
Name:PAPA, CALLIE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:PAPA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15612 HIGHWAY 7 STE 338
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3525
Mailing Address - Country:US
Mailing Address - Phone:612-361-9790
Mailing Address - Fax:
Practice Address - Street 1:15612 HIGHWAY 7 STE 338
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3525
Practice Address - Country:US
Practice Address - Phone:612-361-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3795106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist