Provider Demographics
NPI:1043311368
Name:NORTH SUBURBAN COUNSELING CTR
Entity Type:Organization
Organization Name:NORTH SUBURBAN COUNSELING CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WESCHESHERMAY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:763-784-3008
Mailing Address - Street 1:425 COON RAPIDS BLVD
Mailing Address - Street 2:#200
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433
Mailing Address - Country:US
Mailing Address - Phone:763-784-3008
Mailing Address - Fax:763-784-3647
Practice Address - Street 1:425 COON RAPIDS BLVD
Practice Address - Street 2:#200
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-784-3008
Practice Address - Fax:763-784-3647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN801741MHC251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management