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Organization
ATTACHMENT AND FAMILY CENTER OF MINNESOTA
Active
Organization
ATTACHMENT AND FAMILY CENTER OF MINNESOTA
Active
Other names
Family Attachment and Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY TODD NICHOLS (EXESCUTIVE DIRECTOR)
(952) 234-4632
Entity
Organization
Contact information
Practice address
102 N CHESTNUT ST, CHASKA, MN 55318-1918
(952) 475-2818
(952) 475-3356
Mailing address
102 N CHESTNUT ST, CHASKA, MN 55318-1918
(952) 475-2818
(952) 475-3356
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05142700
—
MN
05
—
118447400
—
MN
Enumeration date
11/20/2006
Last updated
05/10/2020
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