Provider Demographics
NPI:1265945091
Name:DOUTS, MARCI MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:MARIE
Last Name:DOUTS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MARCI
Other - Middle Name:MARIE
Other - Last Name:SPAETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:STAPLES
Mailing Address - State:MN
Mailing Address - Zip Code:56479-0314
Mailing Address - Country:US
Mailing Address - Phone:218-261-0760
Mailing Address - Fax:
Practice Address - Street 1:11 2ND ST SW STE 1
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1483
Practice Address - Country:US
Practice Address - Phone:218-261-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional