Provider Demographics
NPI:1952797086
Name:ROSENTHAL, EVAN (LPCC)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:YVON
Other - Middle Name:
Other - Last Name:LONNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:410 CHURCH ST SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-624-1444
Mailing Address - Fax:612-625-7155
Practice Address - Street 1:410 CHURCH ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0222
Practice Address - Country:US
Practice Address - Phone:612-624-1444
Practice Address - Fax:612-625-7155
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN632101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health