Provider Demographics
NPI:1861836140
Name:SACIN, TINA M (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:SACIN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:LIVINGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:NEIGHBORHOOD INVOLVEMENT PROGRAM
Mailing Address - Street 2:2431 HENNEPIN AVE
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405
Mailing Address - Country:US
Mailing Address - Phone:612-746-8529
Mailing Address - Fax:612-374-3323
Practice Address - Street 1:SACIN PSYCHOTHERAPY
Practice Address - Street 2:4725 EXCELSIOR
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-746-8529
Practice Address - Fax:612-374-3323
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01241103T00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist