Provider Demographics
NPI:1124370986
Name:BRENT RICHTER CONSULTING, LLC
Entity Type:Organization
Organization Name:BRENT RICHTER CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:612-384-7263
Mailing Address - Street 1:7218 FORESTVIEW LN N STE 107
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5644
Mailing Address - Country:US
Mailing Address - Phone:763-274-4028
Mailing Address - Fax:763-322-8854
Practice Address - Street 1:7218 FORESTVIEW LN N STE 107
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5644
Practice Address - Country:US
Practice Address - Phone:763-274-4028
Practice Address - Fax:763-322-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPC 00992261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health