Provider Demographics
NPI:1750630141
Name:MERTEN, CORRIE JONETTA (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:CORRIE
Middle Name:JONETTA
Last Name:MERTEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10277 COLORADO RD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1841
Mailing Address - Country:US
Mailing Address - Phone:612-790-2806
Mailing Address - Fax:
Practice Address - Street 1:107 2ND STREET SOUTH
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:MN
Practice Address - Zip Code:55395-7873
Practice Address - Country:US
Practice Address - Phone:320-485-9041
Practice Address - Fax:320-485-9042
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
MN3081106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist