Individual
ELIZABETH A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC, LPCC
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(763) 439-4984
(763) 767-0912
Mailing address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(763) 439-4984
(763) 767-0912
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302188
MN
101YM0800X
Mental Health Counselor
Primary
2409
MN
Other
Enumeration date
04/12/2011
Last updated
10/23/2023
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