Provider Demographics
NPI:1518623842
Name:ELFMANN, MATTHEW (MA LADC, LPCC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ELFMANN
Suffix:
Gender:M
Credentials:MA LADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 UNIVERSITY AVE NE APT 320
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2682
Mailing Address - Country:US
Mailing Address - Phone:612-719-8764
Mailing Address - Fax:
Practice Address - Street 1:7362 UNIVERSITY AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3152
Practice Address - Country:US
Practice Address - Phone:763-404-7508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN03208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty