Provider Demographics
NPI:1841874401
Name:PRAIRIE POINT COUNSELING PLLC
Entity type:Organization
Organization Name:PRAIRIE POINT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPCC
Authorized Official - Phone:701-391-7661
Mailing Address - Street 1:205 4TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3135
Mailing Address - Country:US
Mailing Address - Phone:701-391-7661
Mailing Address - Fax:
Practice Address - Street 1:1400 43RD AVE NE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6140
Practice Address - Country:US
Practice Address - Phone:701-502-6704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)