Individual
COLLEEN CRYSTAL DAVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC LPCC
Contact information
Practice address
2835 W SAINT GERMAIN ST STE 550, SAINT CLOUD, MN 56301-6389
(320) 251-7700
Mailing address
8852 ARKOLA RD, KELSEY, MN 55724-8502
(218) 348-2998
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303967
MN
101YM0800X
Mental Health Counselor
1869
MN
101YP2500X
Professional Counselor
Primary
1869
MN
Other
Enumeration date
12/05/2019
Last updated
06/07/2024
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