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Organization
CEDAR BRANCH COUNSELING GROUP, PLLC
Active
Organization
CEDAR BRANCH COUNSELING GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELIZABETH CLARK LMFT (PLLC MEMBER, FAMILY THERAPIST)
(218) 240-0368
Entity
Organization
Contact information
Practice address
2232 2ND AVE E STE 5, INTERNATIONAL FALLS, MN 56649-4042
(218) 319-7171
(218) 260-4749
Mailing address
2232 2ND AVE E STE 5, INTERNATIONAL FALLS, MN 56649-4042
(218) 319-7171
(218) 260-4749
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1267
MN
101YP2500X
Professional Counselor
1576
MN
106H00000X
Marriage & Family Therapist
Primary
3298
MN
106H00000X
Marriage & Family Therapist
3507
MN
106H00000X
Marriage & Family Therapist
3514
MN
Other
Enumeration date
05/10/2018
Last updated
10/13/2023
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