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Organization
ACQUIRE MENTAL HEALTH CLINIC
Active
Organization
ACQUIRE MENTAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER VAUGHN MS (LMFT)
(218) 820-6626
Entity
Organization
Contact information
Practice address
25282 HAZELWOOD DR, NISSWA, MN 56468
(218) 820-6626
(218) 961-0065
Mailing address
25282 HAZELWOOD DR, NISSWA, MN 56468-2797
(218) 820-6626
(218) 961-0065
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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