Provider Demographics
NPI:1205575057
Name:MEIERDING, SOPHIA LYNN
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LYNN
Last Name:MEIERDING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5346 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-1230
Mailing Address - Country:US
Mailing Address - Phone:612-746-5888
Mailing Address - Fax:651-454-3492
Practice Address - Street 1:5346 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-1230
Practice Address - Country:US
Practice Address - Phone:507-829-6928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28853101YM0800X
MN247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health