Organization
BRAIN BLEACH COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW DAVID HANSEN MS, LPCC (PRINCIPLE)
(712) 392-0953
Entity
Organization
Contact information
Practice address
1851 LADBROOK LN, SAINT CLOUD, MN 56303-4849
(712) 392-0953
Mailing address
1851 LADBROOK LN, SAINT CLOUD, MN 56303-4849
(712) 392-0953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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