Provider Demographics
NPI:1770870719
Name:CONSCIOUS LIVING COUNSELING & EDUCATION CENTER
Entity type:Organization
Organization Name:CONSCIOUS LIVING COUNSELING & EDUCATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMA
Authorized Official - Middle Name:BREE
Authorized Official - Last Name:JENSEN SCHEURER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:701-478-7199
Mailing Address - Street 1:26 ROBERTS ST N
Mailing Address - Street 2:SUITE 114
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-5200
Mailing Address - Country:US
Mailing Address - Phone:701-478-7199
Mailing Address - Fax:701-478-1763
Practice Address - Street 1:26 ROBERTS ST N
Practice Address - Street 2:SUITE 114
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-5200
Practice Address - Country:US
Practice Address - Phone:701-478-7199
Practice Address - Fax:701-478-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health