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General NPI Number Information
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NPI Number | 1164864989
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Entity Type | Organization
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Legal Business Name | LRC COUNSELING, P.A.
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 6950 FRANCE AVE S SUITE 215
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City | EDINA
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State | MN
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Zip | 55435-2008
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Country | US
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Telephone | 612-730-4649
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Fax |
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Provider Business Mailing Address
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Address Line | 3903 MORNINGSIDE RD
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City | EDINA
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State | MN
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Zip | 55416-5024
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Country | US
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Telephone | 612-730-4649
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND PSYCHOTHERAPIST
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Name | MS. LORI ROGNESS CAO
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Credential | M.A. LMFT
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Telephone | 612-730-4649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2064
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License Number State | MN
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