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NPI Code Detail

MEDICARE: KERSTE DECOTEAU LAPC

MEDICARE: KERSTE DECOTEAU LAPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor1132-6-15-21AND
2101YP2500XProfessional Counselor914-8-1-17AND

General Provider Information

NPI Number : 1104227644
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERSTE DECOTEAU LAPC
Provider Business Mailing Address
First Line : 2468 88TH ST
Second Line :
City : WILLOW CITY
State : ND
Zip : 58384-9009
Country : US
Telephone Number : 701-278-1149
Fax Number :
Provider Business Practice Location Address
First Line : 200 HIGHWAY 2 W
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-3532
Country : US
Telephone Number : 701-665-2200
Fax Number : 701-665-2300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2014
Last Update Date : 06/16/2021

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Directions to “ KERSTE DECOTEAU LAPC” Practice Location

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