Healthcare Provider Details

I. General information

NPI: 1588040042
Provider Name (Legal Business Name): LUVERNE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W MAIN ST
LUVERNE MN
56156-1829
US

IV. Provider business mailing address

118 W MAIN ST
LUVERNE MN
56156-1829
US

V. Phone/Fax

Practice location:
  • Phone: 507-525-7090
  • Fax:
Mailing address:
  • Phone: 507-449-6105
  • Fax: 507-449-6106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCC00793
License Number StateMN

VIII. Authorized Official

Name: ERICA HOUGH
Title or Position: COUNSELOR
Credential: MA, LPCC
Phone: 507-525-7090