Individual provider · Type 1 NPI

Ethan Wise, MA

Mental Health Counselor · St. Louis Park, MN

NPI number 1750251997 Active

Practice location

4201 Excelsior Blvd
St. Louis Park, MN 55416-4728

Call (952) 933-8900 Map

Mailing address

4105 Vera Cruz Ave N
Minneapolis, MN 55422-1724

Other practice locations

  • 6600 Lyndale Ave S Ste 110, Richfield, MN 55423-3398 · (612) 205-5332

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

16 other providers at this address

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About NPI 1750251997

Ethan Wise, MA's National Provider Identifier is 1750251997, issued on Nov 11, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Louis Park, MN. The record was last updated on Nov 11, 2025.