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NPI Code Detail

MEDICARE: INTEGRITY COUNSELING SERVICES, LLC

MEDICARE: INTEGRITY COUNSELING SERVICES, 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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1720305261
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRITY COUNSELING SERVICES, LLC
Provider Business Mailing Address
First Line : 7979 77TH STREET CT S
Second Line :
City : COTTAGE GROVE
State : MN
Zip : 55016-2079
Country : US
Telephone Number : 651-815-7297
Fax Number :
Provider Business Practice Location Address
First Line : 7200 HUDSON BLVD N STE 107E
Second Line :
City : OAKDALE
State : MN
Zip : 55128-7098
Country : US
Telephone Number : 651-815-7297
Fax Number :
Authorized Official
Title or Position : MARRIAGE AND FAMILY THERAPIST
Name : KRISTI SMITH
Credential :
Telephone Number : 651-815-7297
Provider Enumeration Date : 04/23/2010
Last Update Date : 04/23/2010

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Directions to “INTEGRITY COUNSELING SERVICES, LLC ” Practice Location

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