Provider Demographics
NPI:1700236809
Name:MROTEK, DANIEL (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MROTEK
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W GRANT ST
Mailing Address - Street 2:APT 19A
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2309
Mailing Address - Country:US
Mailing Address - Phone:612-272-4048
Mailing Address - Fax:
Practice Address - Street 1:3801 W 50TH ST STE 250B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2070
Practice Address - Country:US
Practice Address - Phone:952-522-1860
Practice Address - Fax:612-353-5000
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional