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General NPI Number Information
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NPI Number | 1497557524
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Entity Type | Organization
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Legal Business Name | KNUTSON COUNSELING CLINIC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 5301 102ND TRL N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-2094
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Country | US
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Telephone | 651-999-9986
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 102ND TRL N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-2094
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Country | US
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Telephone | 651-999-9986
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUKE ANDREW KNUTSON
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Credential | LMFT
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Telephone | 651-999-9986
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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 |
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License Number State |
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