Healthcare Provider Details

I. General information

NPI: 1649839879
Provider Name (Legal Business Name): BEYOND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 S POKEGAMA AVE STE B
GRAND RAPIDS MN
55744-3934
US

IV. Provider business mailing address

813 S POKEGAMA AVE STE B
GRAND RAPIDS MN
55744-3934
US

V. Phone/Fax

Practice location:
  • Phone: 218-259-2370
  • Fax:
Mailing address:
  • Phone: 218-999-9432
  • Fax: 218-999-0205

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: MRS. LAURIE TROUMBLY
Title or Position: LPCC
Credential: LPCC
Phone: 218-999-9432