Equilibriya, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

81 Issued in MN

Legal business name

EQUILIBRIYA, LLC

Practice address

105 New England PL Ste 150
Stillwater, MN 55082-2036

Phone

(651) 342-2175

NPI assigned

Aug 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wendy Lee McMahon, LMFT, LADC, CST

Title

Co-Owner

Phone

(651) 342-2175

Specialties & licenses 4

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1801376587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NEW ENGLAND PL STE 150",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550822036",
            "telephone_number": "651-342-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NEW ENGLAND PL STE 150",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550822036",
            "telephone_number": "651-342-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIYA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-342-2175",
        "authorized_official_credential": "LMFT, LADC, CST"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MN",
            "license": "81",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MN",
            "license": "3313",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303560",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon A Engdahl, MSW LICSW
• Kelsey Elizabeth Engelbart, OD
• Brian Michael Engelen, LPCC
• Kathleen Engh, MA, LPCC
• Enhance PT LLC
• Ford C Erickson, MD
• Jill Danette Erickson, MS, CCC, SLP
• Dean Michael Erie, PT
• Margret O Erlandson
• Laura M Eryou, RPH

• Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.