Organization
FAMILYMEANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA HANSEN (CREDENTIALING COORDINATOR)
(651) 789-4039
Entity
Organization
Contact information
Practice address
1875 NORTHWESTERN AVE S, STILLWATER, MN 55082-7534
(651) 439-4840
(651) 439-4894
Mailing address
1875 NORTHWESTERN AVE S, STILLWATER, MN 55082-7534
(651) 439-4840
(651) 439-4894
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
800792-1-MHC
MN
Other
Enumeration date
06/23/2005
Last updated
07/31/2025
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