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General NPI Number Information
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NPI Number | 1760346324
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Entity Type | Individual
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Provider Name | PETUR EINARSSON MA, LADC
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Gender | Male
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 15251 PLEASANT VALLEY RD
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City | CENTER CITY
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State | MN
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Zip | 55012-9640
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Country | US
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Telephone | 651-213-4524
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | LINDSTROM
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State | MN
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Zip | 55045-0105
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Country | US
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Telephone | 612-232-4448
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Fax | 612-232-4448
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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 | 306895
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License Number State | MN
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