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General NPI Number Information
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NPI Number | 1053650028
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Entity Type | Organization
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Legal Business Name | FAMILY STRENGTHS COUNSELING GROUP, LLC
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 02/11/2013
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Provider Practice Location Address
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Address Line | 199 COON RAPIDS BLVD NW SUITE 210
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City | COON RAPIDS
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State | MN
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Zip | 55433-5831
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Country | US
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Telephone | 651-214-2575
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Fax | 612-605-7135
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Provider Business Mailing Address
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Address Line | 199 COON RAPIDS BLVD NW SUITE 210
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City | COON RAPIDS
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State | MN
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Zip | 55433-5831
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Country | US
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Telephone | 651-214-2575
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Fax | 612-605-7135
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHERINE MARIE PACYGA ROUTT
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Credential | MA, LMFT
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Telephone | 651-214-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1173
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License Number State | MN
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