Provider Demographics
NPI:1710310172
Name:OSUAGWU, HEIDI ANN-GAJDA (LPCC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANN-GAJDA
Last Name:OSUAGWU
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:ANN
Other - Last Name:OSUAGWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:1919 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3435
Mailing Address - Country:US
Mailing Address - Phone:651-266-7999
Mailing Address - Fax:651-266-7850
Practice Address - Street 1:402 UNIVERSITY AVE
Practice Address - Street 2:SUITE 127-A
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-4400
Practice Address - Country:US
Practice Address - Phone:651-266-7900
Practice Address - Fax:651-266-3522
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health