Provider Demographics
NPI:1790106565
Name:SCHARLATT, ANDREA ALESCHA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ALESCHA
Last Name:SCHARLATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:SCHARLATT
Other - Last Name:RAICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:7250 HUDSON BLVD N STE 205
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-7162
Mailing Address - Country:US
Mailing Address - Phone:651-447-3605
Mailing Address - Fax:
Practice Address - Street 1:7250 HUDSON BLVD N STE 205
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-7162
Practice Address - Country:US
Practice Address - Phone:651-447-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-22
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1512101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional