Healthcare Provider Details

I. General information

NPI: 1457288557
Provider Name (Legal Business Name): CC COUNSELING LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 147TH ST W STE 103
APPLE VALLEY MN
55124-7580
US

IV. Provider business mailing address

19260 EVERFIELD AVE
FARMINGTON MN
55024-6018
US

V. Phone/Fax

Practice location:
  • Phone: 651-372-1430
  • Fax:
Mailing address:
  • Phone: 651-249-6579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: HALAINA CHRISTENSEN
Title or Position: CEO/PRESIDENT
Credential: LICSW
Phone: 651-249-6579