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General NPI Number Information
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NPI Number | 1801968300
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICE OF MINNESOTA
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 333 LITCHFIELD AVENUE SW
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City | WILLMAR
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State | MN
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Zip | 56201-3352
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Country | US
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Telephone | 320-235-5411
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Fax | 320-235-2601
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Provider Business Mailing Address
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Address Line | 333 LITCHFIELD AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-3352
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Country | US
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Telephone | 320-235-5411
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Fax | 320-235-2601
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Authorized Official
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Title or Position | MENTAL HEALTH PROFESSIONAL
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Name | MS. DIANNE LOUISE HALTERMAN
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Credential | L.P.C., N.C.C.
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Telephone | 320-235-5411
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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 | 00130
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NCC 44742
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License Number State | MN
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