Provider Demographics
NPI:1285786608
Name:ALTERNATIVE COUNSELING CLINIC
Entity type:Organization
Organization Name:ALTERNATIVE COUNSELING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHYREE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-780-4440
Mailing Address - Street 1:8990 SPRINGBROOK DR NW
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5850
Mailing Address - Country:US
Mailing Address - Phone:763-780-4440
Mailing Address - Fax:763-780-9219
Practice Address - Street 1:8990 SPRINGBROOK DR NW
Practice Address - Street 2:SUITE 220
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5850
Practice Address - Country:US
Practice Address - Phone:763-780-4440
Practice Address - Fax:763-780-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2641430261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6G316ALOtherBLUE CROSS OF MINNESOTA
MN2113638OtherMHP OF MINNESOTA
MN58552ALOtherBLUE CROSS OF MINNESOTA
MN107346OtherUCARE MINNESOTA
MN58554ALOtherBLUE CROSS OF MINNESOTA