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General NPI Number Information
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NPI Number | 1154727105
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Entity Type | Individual
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Provider Name | STEPHANIE RAE CLAUSEN-SWENSON MA, LPCC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 641 1ST AVE STE 2
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City | WESTBROOK
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State | MN
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Zip | 56183-9587
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Country | US
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Telephone | 712-898-3695
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42
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City | STORDEN
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State | MN
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Zip | 56174-0042
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Country | US
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Telephone | 712-898-3695
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Fax |
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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 | 2975
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License Number State | MN
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