Healthcare Provider Details

I. General information

NPI: 1265945091
Provider Name (Legal Business Name): MARCI MARIE DOUTS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCI MARIE SPAETH

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 MAPLE ST
BRAINERD MN
56401-3770
US

IV. Provider business mailing address

PO BOX 314
STAPLES MN
56479-0314
US

V. Phone/Fax

Practice location:
  • Phone: 218-454-3826
  • Fax: 218-454-1024
Mailing address:
  • Phone: 218-261-0760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC01661
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: