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General NPI Number Information
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NPI Number | 1437781515
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Entity Type | Organization
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Legal Business Name | AUTONOMY COUNSELING, PLLC
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 800 HOLIDAY DR STE 170
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City | MOORHEAD
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State | MN
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Zip | 56560-4400
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Country | US
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Telephone | 218-979-3828
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Fax | 218-231-8914
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Provider Business Mailing Address
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Address Line | 800 HOLIDAY DR STE 170
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City | MOORHEAD
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State | MN
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Zip | 56560-4400
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Country | US
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Telephone | 218-979-3828
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARSHA MARIE WERNER
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Credential | LMFT
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Telephone | 360-850-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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