Organization
LIVEWELL COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SKY SMITH LICSW (PSYCHOTHERAPIST)
(507) 951-3874
Entity
Organization
Contact information
Practice address
1500 1ST AVE NE STE 204, ROCHESTER, MN 55906-4170
(507) 951-3874
Mailing address
1301 8TH AVE NE, ROCHESTER, MN 55906-7067
(507) 951-3874
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20593
MN
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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