Organization
LAKES COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INTISAR OMAR HUSSEIN MSW LICSW (PRESIDENT)
(612) 412-3318
Entity
Organization
Contact information
Practice address
121 HENNEPIN AVE, MINNEAPOLIS, MN 55401-1802
(612) 412-3318
(612) 288-1805
Mailing address
121 HENNEPIN AVE, MINNEAPOLIS, MN 55401-1802
(612) 412-3318
(612) 288-1805
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
05/03/2025
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