Provider Demographics
NPI:1588057392
Name:BEUTEL, LINDA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BEUTEL
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3251
Mailing Address - Country:US
Mailing Address - Phone:952-746-2522
Mailing Address - Fax:952-746-0887
Practice Address - Street 1:600 TWELVE OAKS CENTER DRIVE
Practice Address - Street 2:642D
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-5539
Practice Address - Country:US
Practice Address - Phone:952-999-3624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1464101YP2500X
MN1106101YP2500X
AZLPC-19464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional