Healthcare Provider Details

I. General information

NPI: 1124967930
Provider Name (Legal Business Name): LISA HOLTER COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2187 11K ST SW
WASHBURN ND
58577-4129
US

IV. Provider business mailing address

2187 11K ST SW
WASHBURN ND
58577-4129
US

V. Phone/Fax

Practice location:
  • Phone: 218-791-4413
  • Fax:
Mailing address:
  • Phone: 218-791-4413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA HOLTER
Title or Position: OWNER
Credential: LPCC-S
Phone: 218-791-4413