Individual
MR. ROSS G MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
115 N 2ND ST APT 311, MINNEAPOLIS, MN 55401-2768
(218) 234-6789
Mailing address
115 N 2ND ST APT 311, MINNEAPOLIS, MN 55401-2768
(218) 234-6789
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1029-9-15-19-458
ND
101YP2500X
Professional Counselor
Primary
1029-9-15-19-458
ND
Other
Enumeration date
04/15/2022
Last updated
12/18/2024
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