Lisa Bonahoom LLC

Organization Active NPI Marriage & Family Therapist · Long Lake, MN

NPI 1033921069 · NPPES record last updated Jan 27, 2025

Key facts

NPI
1033921069
Entity type
Organization (NPI type 2)
Primary specialty
Marriage & Family Therapist 106H00000X
Legal business name
LISA BONAHOOM LLC
Practice address
1850 W Wayzata Blvd Ste 150
Long Lake, MN 55356-4415
Phone
(952) 240-9404
NPI assigned
Jan 27, 2025
Organization subpart
No

Authorized official

Name
Lisa Bonahoom
Title
Ma, LMFT
Phone
(952) 240-9404

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
106H00000X Yes

Addresses

Primary practice location

1850 W Wayzata Blvd Ste 150
Long Lake, MN 55356-4415

Mailing address

1830 Pheasant Dr
Excelsior, MN 55331-9061
Phone (952) 240-9404

Other providers in Long Lake, MN

All providers in Long Lake, MN · Marriage & Family Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.