Healthcare Provider Details

I. General information

NPI: 1336945096
Provider Name (Legal Business Name): HAGGAR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 WYCLIFF ST # 311
SAINT PAUL MN
55114-1272
US

IV. Provider business mailing address

2515 PLEASANT AVE # 2
MINNEAPOLIS MN
55404-4213
US

V. Phone/Fax

Practice location:
  • Phone: 612-483-4921
  • Fax:
Mailing address:
  • Phone: 612-483-4921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial 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: MICHAEL HAGGAR
Title or Position: OWNER
Credential: LICSW
Phone: 612-483-4921