Provider Demographics
NPI:1124498084
Name:SEVERSON, CLARIBEL (PHD, NCC, LPCC)
Entity type:Individual
Prefix:
First Name:CLARIBEL
Middle Name:
Last Name:SEVERSON
Suffix:
Gender:F
Credentials:PHD, NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W LAUREL ST STE C
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3970
Mailing Address - Country:US
Mailing Address - Phone:218-454-3288
Mailing Address - Fax:218-461-3873
Practice Address - Street 1:401 W LAUREL ST STE C
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3970
Practice Address - Country:US
Practice Address - Phone:218-454-3288
Practice Address - Fax:218-461-3873
Is Sole Proprietor?:No
Enumeration Date:2015-10-04
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1304101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional