Individual
BINOD PRASAD BASAULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LADC, LPCC
Contact information
Practice address
2000 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-3713
(651) 437-4209
Mailing address
9257 LOWER 6TH ST N, LAKE ELMO, MN 55042-4101
(612) 308-5068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305355
MN
101YM0800X
Mental Health Counselor
3344
MN
Other
Enumeration date
08/29/2022
Last updated
08/02/2024
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