Organization
LAKE SUPERIOR COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARI TRINE LICSW (OWNER)
(218) 590-3506
Entity
Organization
Contact information
Practice address
324 W SUPERIOR ST STE 915, DULUTH, MN 55802-1837
(218) 464-6753
(218) 464-6753
Mailing address
324 W SUPERIOR ST STE 915, DULUTH, MN 55802-1837
(218) 464-6753
(218) 464-6753
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689044620
—
MN
Enumeration date
12/18/2020
Last updated
12/18/2020
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