Organization
CENTRAL MINNESOTA COUSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS O. ANDERSEN M.A. L.P. (OWNER/PSYCHOLOGIST)
(320) 253-4321
Entity
Organization
Contact information
Practice address
1500 NORTHWAY DR, SUITE 1, SAINT CLOUD, MN 56303-4477
(320) 253-4321
(320) 240-8525
Mailing address
1500 NORTHWAY DR, SUITE 1, SAINT CLOUD, MN 56303-4477
(320) 253-4321
(320) 240-8525
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033200233
—
MN
05
—
1699882217
—
MN
05
—
1710992243
—
MN
05
—
1770690380
—
MN
Enumeration date
08/21/2007
Last updated
12/23/2015
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