Organization
PORT OF CROW WING COUNTY, INC
Active
Organization
PORT OF CROW WING COUNTY, INC
Active
Other names
DBA Lakes Area Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY HAIDER (CREDENTIALING MANAGER)
(320) 639-1425
Entity
Organization
Contact information
Practice address
1906 5TH AVE SE, LITTLE FALLS, MN 56345-3317
(320) 632-6647
(320) 632-9525
Mailing address
PO BOX 367, LITTLE FALLS, MN 56345-0367
(320) 632-6647
(320) 639-0014
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006031300
—
MN
01
—
059T5PO
BLUECROSS BLUESHIELD
MN
01
—
131919
U CARE
MN
01
—
34B87PO
BLUECROSS BLUESHIELD
MN
01
—
62-764-39
UNITED BEHAVORIAL HEALTH
MN
01
—
82364
HEALTH PARTNERS
MN
Enumeration date
12/01/2006
Last updated
05/20/2022
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