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General NPI Number Information
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NPI Number | 1053285874
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Entity Type | Organization
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Legal Business Name | FOUR CORNERS COUNSELING LLC
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 300 3RD AVE SE STE 302
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City | ROCHESTER
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State | MN
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Zip | 55904-4681
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Country | US
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Telephone | 507-990-1567
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Fax |
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Provider Business Mailing Address
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Address Line | 440 W BROADWAY
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City | PLAINVIEW
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State | MN
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Zip | 55964-1243
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Country | US
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Telephone | 507-990-1567
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JANNEU A PASSOW
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Credential | LICSW
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Telephone | 507-990-1567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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