Provider Demographics
NPI:1639838915
Name:TROUT, ANNA CHRISTINE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:TROUT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:CHRISTINE
Other - Last Name:HERPERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6040 EARLE BROWN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ELLIE MENTAL HEALTH
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430
Practice Address - Country:US
Practice Address - Phone:952-288-9784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist