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General NPI Number Information
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NPI Number | 1063818631
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Entity Type | Individual
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Provider Name | DARLENE ANTHONISEN MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 201 ARMSTRONG BLVD S
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City | SAINT JAMES
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State | MN
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Zip | 56081-1775
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Country | US
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Telephone | 507-375-3442
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Fax | 507-375-1005
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Provider Business Mailing Address
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Address Line | 421 9TH AVE S
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City | SAINT JAMES
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State | MN
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Zip | 56081-1923
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Country | US
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Telephone | 507-375-3442
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Fax | 507-375-1005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC7298
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC01191
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License Number State | MN
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