=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659165033
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIANA HALSE LPC-MH, LPC, RPT-S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2025
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 SIOUX VALLEY DR
-----------------------------------------------------
City | LUVERNE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56156-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-283-4476
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 511 S CARROLL ST
-----------------------------------------------------
City | ROCK RAPIDS
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51246-1441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 30645
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 2580
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------