CENTRAL MINNESOTA COUSELING CENTER INC. NPI 1457544686

NPI Information

  • NPI: 1457544686
  • Provider Name: CENTRAL MINNESOTA COUSELING CENTER, INC.
  • Classification: Psychologist - 103TC2200X
  • Specialization: Clinical Child & Adolescent
  • Entity Type: Organization
  • Address: 1500 NORTHWAY DR
    SUITE 1
    SAINT CLOUD, MN
    ZIP 56303
  • Phone: (320) 253-4321

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NPI Details

CENTRAL MINNESOTA COUSELING CENTER, INC. is a clinical child and adolescent psychologist in Saint Cloud, MN. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. CENTRAL MINNESOTA COUSELING CENTER, INC. NPI is 1457544686. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1500 NORTHWAY DR
SUITE 1
SAINT CLOUD, MN
ZIP 56303-477
Phone: (320) 253-4321
Fax: (320) 240-8525

The provider's authorized official is Dennis O. Andersen .
The authorized official title is Owner/psychologist and has the following contact phone number (320) 253-4321.

The enumeration date for this NPI number is 8/21/2007 and was last updated on 12/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalNo
2103TC1900XPsychologistCounselingNo
3103TF0000XPsychologistFamilyNo
4103TC2200XPsychologistClinical Child & AdolescentYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11699882217MEDICAIDMINNESOTA
21033200233MEDICAIDMINNESOTA
31770690380MEDICAIDMINNESOTA
41710992243MEDICAIDMINNESOTA

What is NPI?

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This page was last updated on: 3/30/2025

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