Provider Demographics
NPI:1770001372
Name:OBERLANDER, EMILY (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:OBERLANDER
Suffix:
Gender:F
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 1:4052 ELLIOT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407
Mailing Address - Country:US
Mailing Address - Phone:612-387-4378
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD
Practice Address - Street 2:#216
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55407
Practice Address - Country:US
Practice Address - Phone:952-831-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-03
Last Update Date:2017-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health