Healthcare Provider Details

I. General information

NPI: 1700086782
Provider Name (Legal Business Name): MCPHERSON COUNSELING SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 25TH AVE S SUITE 109
SAINT CLOUD MN
56301-4820
US

IV. Provider business mailing address

600 25TH AVE S SUITE 109
SAINT CLOUD MN
56301-4820
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-0343
  • Fax: 320-654-0318
Mailing address:
  • Phone: 320-255-0343
  • Fax: 320-654-0318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13073
License Number StateMN

VIII. Authorized Official

Name: MS. ERIN PAIGE MCPHERSON
Title or Position: CORPORATION PRESIDENT/LICSW
Credential: MSW, LICSW
Phone: 320-255-0343