Provider Demographics
NPI:1548603731
Name:CONNECTIONS COUNSELING
Entity Type:Organization
Organization Name:CONNECTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:SLAVIK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LAMFT
Authorized Official - Phone:651-304-7667
Mailing Address - Street 1:15252 W FREEWAY DR NE STE 1
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-8120
Mailing Address - Country:US
Mailing Address - Phone:651-304-7667
Mailing Address - Fax:
Practice Address - Street 1:15252 W FREEWAY DR NE STE 1
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-8120
Practice Address - Country:US
Practice Address - Phone:651-304-7667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01185251S00000X
MN2432251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health