Provider Demographics
NPI:1548627896
Name:HENGEL, ALICIA M (LPCC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:HENGEL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-3822
Mailing Address - Country:US
Mailing Address - Phone:507-453-9563
Mailing Address - Fax:
Practice Address - Street 1:601 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3822
Practice Address - Country:US
Practice Address - Phone:507-453-9563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional