Provider Demographics
NPI:1780074989
Name:LEIN, JUSTINA MAUREEN (MA, LAMFT)
Entity type:Individual
Prefix:MRS
First Name:JUSTINA
Middle Name:MAUREEN
Last Name:LEIN
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 COLFAX AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1402
Mailing Address - Country:US
Mailing Address - Phone:612-668-2720
Mailing Address - Fax:612-668-2730
Practice Address - Street 1:227 COLFAX AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1402
Practice Address - Country:US
Practice Address - Phone:612-668-2720
Practice Address - Fax:612-668-2730
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3116390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program