Provider Demographics
NPI:1144641853
Name:MINNESOTA MULTICULTURAL COUNSELING AND CONSULTANT
Entity type:Organization
Organization Name:MINNESOTA MULTICULTURAL COUNSELING AND CONSULTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGN
Authorized Official - Middle Name:OCHALLA
Authorized Official - Last Name:NYANG
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-636-8926
Mailing Address - Street 1:542 82ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55432-1907
Mailing Address - Country:US
Mailing Address - Phone:612-636-8926
Mailing Address - Fax:952-466-6787
Practice Address - Street 1:542 82ND AVE NE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-1907
Practice Address - Country:US
Practice Address - Phone:612-636-8926
Practice Address - Fax:952-466-6787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health