Provider Demographics
NPI:1295696334
Name:FIELDSON, ADAM TODD
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:TODD
Last Name:FIELDSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 OREN AVE N STE 203
Mailing Address - Street 2:STE 203
Mailing Address - City:OAK PARK HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7401 METRO BLVD STE 425
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3011
Practice Address - Country:US
Practice Address - Phone:651-217-1480
Practice Address - Fax:833-942-5926
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC05305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional