Provider Demographics
NPI:1235837501
Name:DANIELLE CARLSON COUNSELING, LLC
Entity Type:Organization
Organization Name:DANIELLE CARLSON COUNSELING, LLC
Other - Org Name:EQUINE ELEVATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-743-8091
Mailing Address - Street 1:15198 IRISH AVE N
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-9444
Mailing Address - Country:US
Mailing Address - Phone:612-743-8091
Mailing Address - Fax:
Practice Address - Street 1:15198 IRISH AVE N
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-9444
Practice Address - Country:US
Practice Address - Phone:612-743-8091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIELLE CARLSON COUNSELING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-16
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679877252OtherLMFT