Provider Demographics
NPI:1447795596
Name:CONCEPTUAL COUNSELING & ASSESSMENT
Entity Type:Organization
Organization Name:CONCEPTUAL COUNSELING & ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMMON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LADC, LMFT
Authorized Official - Phone:952-564-3000
Mailing Address - Street 1:151 W BURNSVILLE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2525
Mailing Address - Country:US
Mailing Address - Phone:952-564-3000
Mailing Address - Fax:
Practice Address - Street 1:151 W BURNSVILLE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2525
Practice Address - Country:US
Practice Address - Phone:952-564-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIONS MINNESOTA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder