Provider Demographics
NPI:1639594575
Name:CLOUTIER, TASIA (LPCC)
Entity Type:Individual
Prefix:
First Name:TASIA
Middle Name:
Last Name:CLOUTIER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20288 HIGHWAY 15 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5684
Mailing Address - Country:US
Mailing Address - Phone:320-587-2326
Mailing Address - Fax:
Practice Address - Street 1:20288 HIGHWAY 15 N
Practice Address - Street 2:SUITE 100
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5684
Practice Address - Country:US
Practice Address - Phone:320-587-2326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-01
Last Update Date:2014-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health