Provider Demographics
NPI:1477437119
Name:STAHL, ALISSA ROSE (LPCC)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:ROSE
Last Name:STAHL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PARK AVE UNIT 224
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1117
Mailing Address - Country:US
Mailing Address - Phone:507-273-8448
Mailing Address - Fax:
Practice Address - Street 1:1150 MONTREAL AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2393
Practice Address - Country:US
Practice Address - Phone:507-517-1956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional