Provider Demographics
NPI:1285296962
Name:LERFALD, ELIZABETH J (LMFT, LADC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:LERFALD
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6776 LAKE DR STE 170
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1201
Mailing Address - Country:US
Mailing Address - Phone:612-567-7737
Mailing Address - Fax:763-951-2820
Practice Address - Street 1:6776 LAKE DR STE 170
Practice Address - Street 2:
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55014-1201
Practice Address - Country:US
Practice Address - Phone:612-567-7737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305407101YA0400X
MN4324101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)