Central Minnesota Couseling Center, INC.
Psychologist, Clinical Child & Adolescent in Saint Cloud, MN. Organization (NPI-2).
NPI number1457544686
StatusActive
Last updated in NPPESDec 23, 2015
Details
- NPI
- 1457544686
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Minnesota Couseling Center, INC.
- Organization subpart
- No
- Enumeration date
- Aug 21, 2007
- Last updated
- Dec 23, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | – | – | Yes |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 103TC1900X | Psychologist, Counseling | – | – | |
| 103TF0000X | Psychologist, Family | – | – |
Practice location
1500 Northway DrSuite 1
Saint Cloud, MN 56303-4477
Phone 320-253-4321 · Fax 320-240-8525
Mailing address
1500 Northway DrSuite 1
Saint Cloud, MN 56303-4477
Phone 320-253-4321 · Fax 320-240-8525
Authorized official
Dennis O. Andersen
Owner/Psychologist
3202534321
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