MEDICARE: COUNSELING RESOURCES OF CENTRAL MINNESOTA, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	13586	MN

General Provider Information

NPI Number	:	1467607085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING RESOURCES OF CENTRAL MINNESOTA, P.A.

Provider Business Mailing Address
First Line	:	100 2ND AVE S
Second Line	:	SUITE 202
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-1476
Country	:	US
Telephone Number	:	320-217-5790
Fax Number	:	320-217-5923

Provider Business Practice Location Address
First Line	:	100 2ND AVE S
Second Line	:	SUITE 202
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-1476
Country	:	US
Telephone Number	:	320-217-5790
Fax Number	:	320-217-5923

Authorized Official
Title or Position	:	CEO
Name	:	SARAH ELIZABETH MEISINGER
Credential	:	MSW, LICSW
Telephone Number	:	320-271-5790

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	11/24/2008

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