Provider Demographics
NPI:1346459260
Name:CONSULTATION & DESIGN LLC
Entity Type:Organization
Organization Name:CONSULTATION & DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAM THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:651-438-2680
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55964-0443
Mailing Address - Country:US
Mailing Address - Phone:651-438-2680
Mailing Address - Fax:651-319-0106
Practice Address - Street 1:202 7TH ST E
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2103
Practice Address - Country:US
Practice Address - Phone:651-438-2680
Practice Address - Fax:651-319-0106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN24D51HEOtherBLUE SHIELD