Provider Demographics
NPI:1760098164
Name:LIMINAL SPACE COUNSELING INC
Entity Type:Organization
Organization Name:LIMINAL SPACE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYASEKERA
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMFT
Authorized Official - Phone:651-605-6022
Mailing Address - Street 1:1053 GRAND AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3074
Mailing Address - Country:US
Mailing Address - Phone:651-605-6022
Mailing Address - Fax:651-705-8077
Practice Address - Street 1:1053 GRAND AVE STE 115
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3074
Practice Address - Country:US
Practice Address - Phone:651-605-6022
Practice Address - Fax:651-705-8077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty