Provider Demographics
NPI:1831948124
Name:BANYAN TREE COUNSELING PLLC
Entity type:Organization
Organization Name:BANYAN TREE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTIER-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LPC-MH, LMHC
Authorized Official - Phone:402-926-8858
Mailing Address - Street 1:215 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:MN
Mailing Address - Zip Code:56156-1468
Mailing Address - Country:US
Mailing Address - Phone:402-926-8858
Mailing Address - Fax:
Practice Address - Street 1:215 N CEDAR ST STE B
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:MN
Practice Address - Zip Code:56156-1626
Practice Address - Country:US
Practice Address - Phone:507-920-9170
Practice Address - Fax:507-449-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty