Provider Demographics
NPI:1760102131
Name:SKINNER-DRAWZ PSYCHOTHERAPY L.L.C.
Entity Type:Organization
Organization Name:SKINNER-DRAWZ PSYCHOTHERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:ALISON
Authorized Official - Last Name:SKINNER-DRAWZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-232-6894
Mailing Address - Street 1:4848 SPARROW RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3219
Mailing Address - Country:US
Mailing Address - Phone:612-232-6894
Mailing Address - Fax:
Practice Address - Street 1:1001 TWELVE OAKS CENTER DR STE 1002A
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4301
Practice Address - Country:US
Practice Address - Phone:612-232-6894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN17638OtherSTATE OF MINNETOSA