Provider Demographics
NPI:1851618557
Name:COUNSELING & ASSESSMENT CENTER, INC
Entity Type:Organization
Organization Name:COUNSELING & ASSESSMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLEESS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LADC,CCDP-D
Authorized Official - Phone:763-377-3270
Mailing Address - Street 1:33945 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008
Mailing Address - Country:US
Mailing Address - Phone:763-377-3270
Mailing Address - Fax:763-452-0331
Practice Address - Street 1:105 W MAIN ST.
Practice Address - Street 2:
Practice Address - City:ISANTI
Practice Address - State:MN
Practice Address - Zip Code:55040
Practice Address - Country:US
Practice Address - Phone:763-377-3270
Practice Address - Fax:763-452-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00037251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health