Provider Demographics
NPI:1124597133
Name:TAKE FLIGHT COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:TAKE FLIGHT COUNSELING SERVICES LLC
Other - Org Name:TAKE FLIGT COUNSELING SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:LORAINE
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-554-9661
Mailing Address - Street 1:4318 34TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3831
Mailing Address - Country:US
Mailing Address - Phone:612-554-9661
Mailing Address - Fax:651-645-5970
Practice Address - Street 1:1821 UNIVERSITY AVE W STE S303
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2813
Practice Address - Country:US
Practice Address - Phone:612-554-9661
Practice Address - Fax:651-645-5970
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAKE FLIGHT COUNSELING SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-19
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty