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NPI Code Detail

MEDICARE: LITTLE HOUSE COUNSELING PLLC

MEDICARE: LITTLE HOUSE COUNSELING PLLC
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1518678648
Entity Type Code : Organization
Provider Name (Legal Business Name) : LITTLE HOUSE COUNSELING PLLC
Provider Business Mailing Address
First Line : 4818 30TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-1306
Country : US
Telephone Number : 952-836-6789
Fax Number :
Provider Business Practice Location Address
First Line : 4822 30TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-1306
Country : US
Telephone Number : 952-836-6789
Fax Number :
Authorized Official
Title or Position : PSYCHOTHERAPIST /OWNER
Name : MARLYSSA M THORSON
Credential : LPCC
Telephone Number : 952-836-6789
Provider Enumeration Date : 12/09/2022
Last Update Date : 12/09/2022

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Directions to “LITTLE HOUSE COUNSELING PLLC ” Practice Location

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