Provider Demographics
NPI:1720465669
Name:REDWOOD COUNSELING LLC
Entity Type:Organization
Organization Name:REDWOOD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:NORAH
Authorized Official - Last Name:RUSCHMEYER BOWE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:320-282-6027
Mailing Address - Street 1:4201 QUAKER TRL NE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-1744
Mailing Address - Country:US
Mailing Address - Phone:320-282-6027
Mailing Address - Fax:
Practice Address - Street 1:4201 QUAKER TRL NE
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-1744
Practice Address - Country:US
Practice Address - Phone:320-282-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health