Provider Demographics
NPI:1144399288
Name:FOUNDATIONS COUNSELING SERVICES
Entity Type:Organization
Organization Name:FOUNDATIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:HANS
Authorized Official - Middle Name:C
Authorized Official - Last Name:SKULSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:952-393-6828
Mailing Address - Street 1:7575 GOLDEN VALLEY ROAD
Mailing Address - Street 2:SUITE 133
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427
Mailing Address - Country:US
Mailing Address - Phone:763-546-8175
Mailing Address - Fax:763-546-2197
Practice Address - Street 1:7575 GOLDEN VALLEY RD STE 133
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4570
Practice Address - Country:US
Practice Address - Phone:763-546-8175
Practice Address - Fax:763-546-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1300106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN150158500Medicaid