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General NPI Number Information
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NPI Number | 1295890192
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Entity Type | Organization
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Legal Business Name | OUTREACH COUNSELING & CONSULTING SERVICES, INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3570 LEXINGTON AVE N SUITE 100
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City | SHOREVIEW
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State | MN
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Zip | 55126-8049
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Country | US
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Telephone | 651-481-0664
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Fax | 651-481-3907
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Provider Business Mailing Address
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Address Line | 3570 LEXINGTON AVE N SUITE 100
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City | SHOREVIEW
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State | MN
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Zip | 55126-8049
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Country | US
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Telephone | 651-481-0664
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Fax | 651-481-3907
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUZMILA AMUNDSON
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Credential |
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Telephone | 651-481-0664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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