Provider Demographics
NPI:1154727105
Name:CLAUSEN-SWENSON, STEPHANIE RAE (MA, LPCC, LMFT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RAE
Last Name:CLAUSEN-SWENSON
Suffix:
Gender:F
Credentials:MA, LPCC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:STORDEN
Mailing Address - State:MN
Mailing Address - Zip Code:56174-0042
Mailing Address - Country:US
Mailing Address - Phone:712-898-3695
Mailing Address - Fax:
Practice Address - Street 1:641 1ST AVE STE 2
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:MN
Practice Address - Zip Code:56183-9587
Practice Address - Country:US
Practice Address - Phone:712-898-3695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty