Healthcare Provider Details

I. General information

NPI: 1043923576
Provider Name (Legal Business Name): DIAMOND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14991 75TH AVE NE
ATWATER MN
56209-9580
US

IV. Provider business mailing address

576 MERRILL ST SW
HUTCHINSON MN
55350-2765
US

V. Phone/Fax

Practice location:
  • Phone: 320-592-4545
  • Fax:
Mailing address:
  • Phone: 320-282-8031
  • 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: STEPHANIE RAE OKASH
Title or Position: THERAPIST
Credential: LICSW
Phone: 320-282-8031