Individual
AUDREY KAZMIERCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAC, LPCC, MAC
Contact information
Practice address
418 EAST ROSSER AVENUE, SUITE 304, BISMARK, ND 58301-4046
(701) 471-1170
Mailing address
418 EAST ROSSER AVENUE, SUITE 304, BISMARK, ND 58301-4046
(701) 471-1170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC1243
ND
101YP2500X
Professional Counselor
LPCC93-7-1-91-65
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21792
BCBS
ND
01
—
22619
BCBS
ND
Enumeration date
09/19/2008
Last updated
09/19/2008
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