Provider Demographics
NPI:1659130615
Name:BORELL, ANNA (LPCC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BORELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 12TH ST E STE 102
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-2337
Mailing Address - Country:US
Mailing Address - Phone:952-361-9700
Mailing Address - Fax:
Practice Address - Street 1:7525 MITCHELL RD STE 215
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-1957
Practice Address - Country:US
Practice Address - Phone:952-361-9700
Practice Address - Fax:320-864-6130
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional