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General NPI Number Information
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NPI Number | 1609471697
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Entity Type | Individual
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Provider Name | BARBARA LYNN WISNIEWSKI LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 400 S 2ND ST STE 125
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City | PRINCETON
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State | MN
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Zip | 55371-1878
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Country | US
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Telephone | 612-787-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 10780 201ST AVE NW
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City | ELK RIVER
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State | MN
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Zip | 55330-2068
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Country | US
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Telephone | 612-408-5407
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC01905
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License Number State | MN
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