Provider Demographics
NPI:1457654188
Name:STRONG FOUNDATIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:STRONG FOUNDATIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MISTYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:507-491-4848
Mailing Address - Street 1:303 1ST AVE NE STE 103
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5373
Mailing Address - Country:US
Mailing Address - Phone:507-491-4848
Mailing Address - Fax:507-331-8677
Practice Address - Street 1:303 1ST AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5373
Practice Address - Country:US
Practice Address - Phone:507-491-4848
Practice Address - Fax:507-331-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty