=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144318189
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAMARIX COUNSELING SERVICES PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12533 355TH ST
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56310-8736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-363-8877
-----------------------------------------------------
Fax | 320-363-8821
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12533 355TH ST
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56310-8736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-363-8877
-----------------------------------------------------
Fax | 320-363-8821
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | JANE BARBARA BLOMMEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 320-363-8877
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 6485LICSW
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6485LICSW
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 6485LICSW
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------