Provider Demographics
NPI:1265174387
Name:TUNELL, RICHARD FREDOLPH (LPCC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:FREDOLPH
Last Name:TUNELL
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 HAMMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-6066
Mailing Address - Country:US
Mailing Address - Phone:218-590-6753
Mailing Address - Fax:
Practice Address - Street 1:6700 HAMMOND AVE
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-6066
Practice Address - Country:US
Practice Address - Phone:218-590-6753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3211101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional