Provider Demographics
NPI:1942867783
Name:ARELLANO, MICHAELA (MPS, LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:MPS, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19912 EXCELSIOR LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8419
Mailing Address - Country:US
Mailing Address - Phone:612-702-6012
Mailing Address - Fax:
Practice Address - Street 1:8085 WAYZATA BLVD STE 215
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1457
Practice Address - Country:US
Practice Address - Phone:651-387-5312
Practice Address - Fax:651-493-2798
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02219101YP2500X
MN304822101YA0400X
MN2637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)