Provider Demographics
NPI:1780014399
Name:MINNESOTA MULTI CULTURAL COUNSELLING AND CONSULTANT INC
Entity Type:Organization
Organization Name:MINNESOTA MULTI CULTURAL COUNSELLING AND CONSULTANT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAGN
Authorized Official - Middle Name:O
Authorized Official - Last Name:NYANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-636-8926
Mailing Address - Street 1:6933 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2704
Mailing Address - Country:US
Mailing Address - Phone:651-283-4745
Mailing Address - Fax:
Practice Address - Street 1:6933 17TH AVE S
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2704
Practice Address - Country:US
Practice Address - Phone:651-283-4745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00670261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health