Individual
DIANE MARIE CERVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
201 LAKE AVE, PARK RAPIDS, MN 56470-1410
(218) 366-0580
Mailing address
201 LAKE AVE, PARK RAPIDS, MN 56470-1410
(503) 956-1359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
08-06-34
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
567
MN
Other
Enumeration date
01/07/2008
Last updated
05/01/2024
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