Organization
KRISMA COUNSELING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAURICE LEE SHOEN LICSW (CO-OWMER)
(507) 399-2149
Entity
Organization
Contact information
Practice address
112 W 1ST ST, SUITE 104, FAIRMONT, MN 56031-1743
(507) 399-2149
(507) 399-2159
Mailing address
112 W 1ST ST, SUITE 104, FAIRMONT, MN 56031-1743
(507) 399-2149
(507) 399-2159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17553
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1DH74KR
BLUE CROSS BLUE SHIELD
MN
05
—
6574051
—
MN
Enumeration date
03/30/2012
Last updated
03/30/2012
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