Provider Demographics
NPI:1952769739
Name:WOOD PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:WOOD PSYCHOTHERAPY LLC
Other - Org Name:WOOD PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:612-444-8039
Mailing Address - Street 1:6575 141ST AVE NW STE 110
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5751
Mailing Address - Country:US
Mailing Address - Phone:612-444-8039
Mailing Address - Fax:612-324-7423
Practice Address - Street 1:6575 141ST AVE NW STE 110
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-5751
Practice Address - Country:US
Practice Address - Phone:612-444-8039
Practice Address - Fax:612-324-7423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty