Provider Demographics
NPI:1821760158
Name:BLUE NEST COUNSELING LLC
Entity Type:Organization
Organization Name:BLUE NEST COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:JONETTA
Authorized Official - Last Name:MERTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-790-2806
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:MAYER
Mailing Address - State:MN
Mailing Address - Zip Code:55360-0024
Mailing Address - Country:US
Mailing Address - Phone:612-790-2806
Mailing Address - Fax:
Practice Address - Street 1:212 ASH AVE N STE 3
Practice Address - Street 2:
Practice Address - City:MAYER
Practice Address - State:MN
Practice Address - Zip Code:55360-8557
Practice Address - Country:US
Practice Address - Phone:612-790-2806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)