Provider Demographics
NPI:1689682155
Name:ANN E BOEKHOFF MA LP PA
Entity Type:Organization
Organization Name:ANN E BOEKHOFF MA LP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BOEKHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MA LP LMFT
Authorized Official - Phone:651-647-3492
Mailing Address - Street 1:91 N SNELLING AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6756
Mailing Address - Country:US
Mailing Address - Phone:651-647-3492
Mailing Address - Fax:651-641-1074
Practice Address - Street 1:91 N SNELLING AVE
Practice Address - Street 2:STE 200
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6756
Practice Address - Country:US
Practice Address - Phone:651-647-3492
Practice Address - Fax:651-641-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1197103T00000X
MN334106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN57763B0OtherBCBS