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NPI Code Detail

MEDICARE: COURTNEY VAN DEN BUSSCHE-DOLL LPCC

MEDICARE: COURTNEY VAN DEN BUSSCHE-DOLL LPCC
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
1101YP2500XProfessional CounselorCC02001MN

General Provider Information

NPI Number : 1699246983
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY VAN DEN BUSSCHE-DOLL LPCC
Provider Business Mailing Address
First Line : 1547 30TH AVE S
Second Line :
City : MOORHEAD
State : MN
Zip : 56560-5149
Country : US
Telephone Number : 218-287-4338
Fax Number : 218-287-5928
Provider Business Practice Location Address
First Line : 1041 HAWK ST
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-6958
Country : US
Telephone Number : 218-844-6853
Fax Number : 218-844-6854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2018
Last Update Date : 10/27/2021

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Directions to “ COURTNEY VAN DEN BUSSCHE-DOLL LPCC” Practice Location

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