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General NPI Number Information
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NPI Number | 1316605934
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Entity Type | Individual
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Provider Name | RENEE ELAINE LACROIX LPCC, LADC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 28 UNION ST N
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City | MORA
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State | MN
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Zip | 55051-1355
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Country | US
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Telephone | 320-703-8151
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Fax | 320-210-1830
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Provider Business Mailing Address
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Address Line | 4918 XERXES AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55430-3733
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Country | US
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Telephone | 612-554-3195
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 305253
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC04500
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License Number State | MN
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