Provider Demographics
NPI:1649768359
Name:HEARTLAND PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:HEARTLAND PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:LAUREL
Authorized Official - Last Name:STEELY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, LADC
Authorized Official - Phone:612-404-0498
Mailing Address - Street 1:825 NICOLLET MALL STE 1443
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2703
Mailing Address - Country:US
Mailing Address - Phone:612-404-0498
Mailing Address - Fax:888-974-8249
Practice Address - Street 1:825 NICOLLET MALL STE 1443
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2703
Practice Address - Country:US
Practice Address - Phone:612-404-0498
Practice Address - Fax:888-974-8249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MN23463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty