Healthcare Provider Details

I. General information

NPI: 1861355695
Provider Name (Legal Business Name): RESTORATIVE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 UPPER SAINT DENNIS RD
SAINT PAUL MN
55116-2823
US

IV. Provider business mailing address

2117 UPPER SAINT DENNIS RD
SAINT PAUL MN
55116-2823
US

V. Phone/Fax

Practice location:
  • Phone: 651-478-9081
  • Fax:
Mailing address:
  • Phone: 651-478-9081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. LOUIS T ALLEN II
Title or Position: OWNER/CLINICAL THERAPIST
Credential: LICSW
Phone: 651-478-9081