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Organization

SECURE BASE COUNSELING CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JENNIFER LYNN SIMPSON-DAHL MA, LMFT (CEO/OWNER)
(507) 301-3412
Entity
Organization

Contact information

Practice address
570 PROFESSIONAL DR, NORTHFIELD, MN 55057-2756
(507) 301-3412
Mailing address
570 PROFESSIONAL DR, NORTHFIELD, MN 55057-2756
(507) 301-3412

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4079
MN
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
133V00000X
Registered Dietitian
163W00000X
Registered Nurse
163WP0808X
Psychiatric/Mental Health Registered Nurse
164W00000X
Licensed Practical Nurse
171R00000X
Interpreter
2080P0006X
Developmental - Behavioral Pediatrics Physician
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
363LP0200X
Pediatric Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
01/13/2012
Last updated
03/30/2022
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