Provider Demographics
NPI:1477698876
Name:COUNSELING CENTER INC
Entity Type:Organization
Organization Name:COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR MS LPCC
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILHELM
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPCC
Authorized Official - Phone:701-232-2791
Mailing Address - Street 1:1111 WESTRAC DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2384
Mailing Address - Country:US
Mailing Address - Phone:701-232-2791
Mailing Address - Fax:701-364-4090
Practice Address - Street 1:1111 WESTRAC DR
Practice Address - Street 2:SUITE 204
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2384
Practice Address - Country:US
Practice Address - Phone:701-232-2791
Practice Address - Fax:701-364-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND36511196111101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN08N06C0OtherBCBS OF MN
NDWIL26947OtherBCBS OF ND