Healthcare Provider Details

I. General information

NPI: 1831461813
Provider Name (Legal Business Name): NORTH WOODS CHRISTIAN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 CONSTELLATION DR
WHITE BEAR LAKE MN
55127-2218
US

IV. Provider business mailing address

PO BOX 234
DULUTH MN
55801-0234
US

V. Phone/Fax

Practice location:
  • Phone: 651-243-2484
  • Fax: 651-925-0045
Mailing address:
  • Phone: 651-243-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2081
License Number StateMN

VIII. Authorized Official

Name: MARK ODLAND
Title or Position: OWNER/LMFT
Credential: MA, LMFT, MDIV
Phone: 651-243-2484