Provider Demographics
NPI:1558731083
Name:KARISSA SCHMOLL COUNSELING, LLC
Entity Type:Organization
Organization Name:KARISSA SCHMOLL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHMOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:701-212-3469
Mailing Address - Street 1:1100 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5012
Mailing Address - Country:US
Mailing Address - Phone:701-212-3469
Mailing Address - Fax:
Practice Address - Street 1:1100 32ND AVE S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5012
Practice Address - Country:US
Practice Address - Phone:701-212-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-26
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1947251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health