Provider Demographics
NPI:1720327364
Name:SCHREIFELS, THERESA J (LMFT)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:J
Last Name:SCHREIFELS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:SCHREIFELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:720 8TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-3420
Mailing Address - Country:US
Mailing Address - Phone:320-420-2234
Mailing Address - Fax:320-251-0217
Practice Address - Street 1:1250 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-1255
Practice Address - Country:US
Practice Address - Phone:320-253-8110
Practice Address - Fax:320-253-1107
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2474106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1720327364Medicaid