Provider Demographics
NPI:1124053756
Name:MEHRHOFF, PATRICIA MARIE (MSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIE
Last Name:MEHRHOFF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:PARTICIA
Other - Middle Name:MARIE
Other - Last Name:PYFFEROEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:760 SOUTHCROSS DR. W. SUITE 103
Mailing Address - Street 2:THE THERAPY SHOP
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306
Mailing Address - Country:US
Mailing Address - Phone:952-835-5090
Mailing Address - Fax:952-835-5090
Practice Address - Street 1:760 SOUTHCROSS DR. W.
Practice Address - Street 2:SUITE 103
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306
Practice Address - Country:US
Practice Address - Phone:952-835-5090
Practice Address - Fax:952-835-5090
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN156401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN446702700Medicaid
MN446702700Medicaid