Provider Demographics
NPI:1770095556
Name:CALL, CORY CHRISTOPHER (LMFT)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:CHRISTOPHER
Last Name:CALL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 COLFAX AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3507
Mailing Address - Country:US
Mailing Address - Phone:612-382-3619
Mailing Address - Fax:
Practice Address - Street 1:345 E 38TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1363
Practice Address - Country:US
Practice Address - Phone:612-243-1600
Practice Address - Fax:612-767-4624
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist