Provider Demographics
NPI:1174719280
Name:TANKENOFF, MARI ROBYN (LMHC, LPCC, LP)
Entity type:Individual
Prefix:DR
First Name:MARI
Middle Name:ROBYN
Last Name:TANKENOFF
Suffix:
Gender:F
Credentials:LMHC, LPCC, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15542 SUSSEX DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-1457
Mailing Address - Country:US
Mailing Address - Phone:505-204-0569
Mailing Address - Fax:
Practice Address - Street 1:621 W LAKE ST STE 350
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2952
Practice Address - Country:US
Practice Address - Phone:612-979-2276
Practice Address - Fax:651-925-0427
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLPCC0112771101YM0800X
NY009443101YM0800X
MNLP3024103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health