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General NPI Number Information
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NPI Number | 1144567546
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Entity Type | Organization
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Legal Business Name | ST CROIX PSYCHIATRIC SERVICES, PLLC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 700 QUALITY LN N
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City | LAKELAND
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State | MN
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Zip | 55043-9624
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Country | US
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Telephone | 612-251-0074
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Fax | 855-758-2853
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | LAKELAND
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State | MN
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Zip | 55043-0252
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Country | US
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Telephone | 612-251-0074
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Fax | 855-758-2853
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Authorized Official
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Title or Position | OWNER
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Name | KARALEE ANN LUBBERS LABRECHE
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Credential | DNP, RN, CNS, CNP
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Telephone | 612-251-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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