Provider Demographics
NPI:1750134698
Name:STRAND, LEVI WILLIS
Entity type:Individual
Prefix:
First Name:LEVI
Middle Name:WILLIS
Last Name:STRAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7590 LYRIC LN NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3251
Mailing Address - Country:US
Mailing Address - Phone:763-236-4370
Mailing Address - Fax:763-236-4370
Practice Address - Street 1:7590 LYRIC LN NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3251
Practice Address - Country:US
Practice Address - Phone:763-236-4370
Practice Address - Fax:763-236-4370
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304355101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)