Healthcare Provider Details

I. General information

NPI: 1982473765
Provider Name (Legal Business Name): DENETTE NARUM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 32ND AVE S STE B
MOORHEAD MN
56560-5012
US

IV. Provider business mailing address

1100 32ND AVE S STE B
MOORHEAD MN
56560-5012
US

V. Phone/Fax

Practice location:
  • Phone: 218-979-9285
  • Fax: 218-477-8199
Mailing address:
  • Phone: 218-979-9285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENETTE NARUM
Title or Position: OWNER
Credential: LICSW
Phone: 218-979-9285