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General NPI Number Information
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NPI Number | 1912538554
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Entity Type | Organization
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Legal Business Name | GREENWAY COUNSELING LLC
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Dates
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Enumeration Date | 02/02/2020
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Last Update Date | 03/15/2020
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Provider Practice Location Address
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Address Line | 372 GREENWAY DR
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City | DELANO
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State | MN
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Zip | 55328-4571
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Country | US
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Telephone | 612-568-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 372 GREENWAY DR
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City | DELANO
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State | MN
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Zip | 55328-4571
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPCC/OWNER
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Name | MELISSA SPICER
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Credential |
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Telephone | 612-839-6212
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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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