Provider Demographics
NPI:1649054925
Name:CACTUS ROSE COUNSELING
Entity type:Organization
Organization Name:CACTUS ROSE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARET
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:701-491-8260
Mailing Address - Street 1:875 34TH AVE E APT 103
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8049
Mailing Address - Country:US
Mailing Address - Phone:701-491-8260
Mailing Address - Fax:
Practice Address - Street 1:875 34TH AVE E APT 103
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8049
Practice Address - Country:US
Practice Address - Phone:701-491-8260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)