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NPI Code Detail

MEDICARE: THERAPEACE COUNSELING, LLC

MEDICARE: THERAPEACE COUNSELING, LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1629624846
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERAPEACE COUNSELING, LLC
Provider Business Mailing Address
First Line : 905 JEFFERSON AVE STE 300
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4740
Country : US
Telephone Number : 651-800-1225
Fax Number :
Provider Business Practice Location Address
First Line : 905 JEFFERSON AVE STE 300
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4740
Country : US
Telephone Number : 651-800-1225
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : LAREESA HOOPER
Credential : LMFT, LADC
Telephone Number : 316-461-3133
Provider Enumeration Date : 08/13/2019
Last Update Date : 08/13/2019

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Directions to “THERAPEACE COUNSELING, LLC ” Practice Location

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