Provider Demographics
NPI:1578451621
Name:EDELSTEIN, LAURA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:EDELSTEIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 LORING LN
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5007
Mailing Address - Country:US
Mailing Address - Phone:126-834-0577
Mailing Address - Fax:
Practice Address - Street 1:5705 LORING LN
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5007
Practice Address - Country:US
Practice Address - Phone:612-834-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3270106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist