Healthcare Provider Details
I. General information
NPI: 1588685010
Provider Name (Legal Business Name): CARRIE L. HJELLMING LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/21/2006
Last Update Date: 12/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 13TH AVE W SUITE 1
DICKINSON ND
58601-4879
US
IV. Provider business mailing address
300 13TH AVE W SUITE 1
DICKINSON ND
58601-4879
US
V. Phone/Fax
- Phone: 701-227-7532
- Fax: 701-227-7575
- Phone: 701-227-7532
- Fax: 701-227-7575
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 467-11-15-01-145 |
| License Number State | ND |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: