Organization
CORNERVINE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MUTALIPASSI LCSW (OWNER)
(701) 773-3381
Entity
Organization
Contact information
Practice address
624 MAIN AVE STE 3A, FARGO, ND 58103-1966
(701) 373-1149
Mailing address
624 MAIN AVE STE 3A, FARGO, ND 58103-1966
(701) 373-1149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/27/2025
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