Healthcare Provider Details

I. General information

NPI: 1245258722
Provider Name (Legal Business Name): COVERED BRIDGE FAMILY RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WEST 5TH STREET
ZUMBROTA MN
55992
US

IV. Provider business mailing address

PO BOX 134
ZUMBROTA MN
55992
US

V. Phone/Fax

Practice location:
  • Phone: 507-732-4136
  • Fax: 888-527-4602
Mailing address:
  • Phone: 507-732-4136
  • Fax: 888-527-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. ANDREA KRISTIN SMOTHERS
Title or Position: OWNER
Credential: MSW LICSW
Phone: 507-732-4136