Provider Demographics
NPI:1023812252
Name:PORTSIDE COUNSELING LLC
Entity type:Organization
Organization Name:PORTSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:320-296-5009
Mailing Address - Street 1:850 ELM ST NE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-1271
Mailing Address - Country:US
Mailing Address - Phone:320-296-5009
Mailing Address - Fax:
Practice Address - Street 1:850 ELM ST NE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1271
Practice Address - Country:US
Practice Address - Phone:320-296-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty