Provider Demographics
NPI:1659811826
Name:AMUNDSON, CORTNEY LYNN (MA LPCC, BCN)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:LYNN
Last Name:AMUNDSON
Suffix:
Gender:F
Credentials:MA LPCC, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 METRO BLVD STE 335
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2356
Mailing Address - Country:US
Mailing Address - Phone:952-992-9646
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD STE 335
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2356
Practice Address - Country:US
Practice Address - Phone:952-992-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional