Healthcare Provider Details

I. General information

NPI: 1720037575
Provider Name (Legal Business Name): CINDY A T HAPPE MSW LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRACARE CIRCLE
ST CLOUD MN
56303
US

IV. Provider business mailing address

3315 ROOSEVELT RD SUITE 200A
ST CLOUD MN
56301
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-5796
  • Fax: 320-229-5179
Mailing address:
  • Phone: 320-229-4069
  • Fax: 320-229-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15109
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: