Organization
CORNELIUS COUNSELING, LLC
Active
Other names
Wellspring Counselors
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA V CORNELIUS LPCC (OWNER)
(651) 895-3624
Entity
Organization
Contact information
Practice address
1405 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-9301
(651) 895-3624
Mailing address
1405 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-9301
(651) 895-3624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC00430
MN
101YP2500X
Professional Counselor
CC00430
MN
102L00000X
Psychoanalyst
CC0430
MN
106H00000X
Marriage & Family Therapist
CC0430
MN
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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