Provider Demographics
NPI:1730202359
Name:HAALAND, MARC H (LPC)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:H
Last Name:HAALAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 GOLDEN VALLEY RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4562
Mailing Address - Country:US
Mailing Address - Phone:763-525-8590
Mailing Address - Fax:763-525-8592
Practice Address - Street 1:19230 EVANS ST NW
Practice Address - Street 2:SUITE 202A
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1573
Practice Address - Country:US
Practice Address - Phone:763-241-8157
Practice Address - Fax:763-241-7670
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional