Individual
MR. DUANE RAYMOND HACKBARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LADC, LMFT
Contact information
Practice address
407 WASHINGTON ST, MONTICELLO, MN 55362-8815
(763) 295-4001
(863) 295-5086
Mailing address
1321 NORTH 13TH STREET, ST CLOUD, MN 56303-2614
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301718
MN
106H00000X
Marriage & Family Therapist
Primary
1841
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
922241043762
PREFERRED ONE
—
01
—
HP52703
HEALTH PARTNERS
—
Enumeration date
06/19/2006
Last updated
05/13/2011
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