Provider Demographics
NPI:1508386939
Name:PATTI VENEKAMP COUNSELING SERVICES, P.C.
Entity Type:Organization
Organization Name:PATTI VENEKAMP COUNSELING SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VENEKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PSYCHOLOGIS
Authorized Official - Phone:320-732-7111
Mailing Address - Street 1:221 LAKE ST S STE 101
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-7121
Mailing Address - Country:US
Mailing Address - Phone:320-732-7111
Mailing Address - Fax:320-732-9038
Practice Address - Street 1:221 LAKE ST S STE 101
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-7121
Practice Address - Country:US
Practice Address - Phone:320-732-7111
Practice Address - Fax:320-732-9038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2812103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty