Provider Demographics
NPI:1356752463
Name:YOUR VISION ACHIEVED, LLC
Entity type:Organization
Organization Name:YOUR VISION ACHIEVED, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:LIDIA
Authorized Official - Last Name:TAPIA-FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-269-5313
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-0363
Mailing Address - Country:US
Mailing Address - Phone:612-269-5313
Mailing Address - Fax:
Practice Address - Street 1:1705 SOUTHCROSS DR W UNIT 101
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-7027
Practice Address - Country:US
Practice Address - Phone:952-225-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2024-04-15
Deactivation Date:2024-02-13
Deactivation Code:
Reactivation Date:2024-02-16
Provider Licenses
StateLicense IDTaxonomies
MN1024106H00000X
MN2386106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty