Healthcare Provider Details

I. General information

NPI: 1104596139
Provider Name (Legal Business Name): LOVE, ME COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N ELLSWORTH RD STE 7A
BOX ELDER SD
57719-2007
US

IV. Provider business mailing address

520 N ELLSWORTH RD STE 7A
BOX ELDER SD
57719-2007
US

V. Phone/Fax

Practice location:
  • Phone: 816-299-0244
  • Fax:
Mailing address:
  • Phone: 816-299-0244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MONICA R. FOSBERG
Title or Position: SOLE MEMBER
Credential: NCC, LPC
Phone: 816-299-0244