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General NPI Number Information
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NPI Number | 1114819935
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Entity Type | Organization
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Legal Business Name | HEALING WATERS COUNSELING & PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 201 NW 4TH ST STE 3
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-2730
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Country | US
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Telephone | 218-259-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 201 NW 4TH ST STE 3
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-2730
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Country | US
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Telephone | 218-259-7797
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Fax |
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | BRANDON PAUL STENZEL
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Credential |
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Telephone | 651-564-1075
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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 |
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License Number State |
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