Provider Demographics
NPI:1578813010
Name:MARKOVICH, ANN E (MA, LMFT, DBT CERTI)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:E
Last Name:MARKOVICH
Suffix:
Gender:F
Credentials:MA, LMFT, DBT CERTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5528 HOLIDAY RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5414
Mailing Address - Country:US
Mailing Address - Phone:651-334-5157
Mailing Address - Fax:
Practice Address - Street 1:PRAIRIECARE
Practice Address - Street 2:9400 ZANE AVE N
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1814
Practice Address - Country:US
Practice Address - Phone:763-762-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2044106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist