Provider Demographics
NPI:1417793845
Name:MAYER, ADAM A (LPCC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:A
Last Name:MAYER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 VIRGINIA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3035
Mailing Address - Country:US
Mailing Address - Phone:651-208-1094
Mailing Address - Fax:
Practice Address - Street 1:5414 W OLD SHAKOPEE CIR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-2766
Practice Address - Country:US
Practice Address - Phone:952-888-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional