Provider Demographics
NPI:1346097888
Name:VERNON CENTER PROFESSIONAL COUNSELING LLC
Entity type:Organization
Organization Name:VERNON CENTER PROFESSIONAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:507-549-3636
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:VERNON CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:56090-0154
Mailing Address - Country:US
Mailing Address - Phone:507-549-3636
Mailing Address - Fax:507-299-7334
Practice Address - Street 1:201 EAST ST S # 14
Practice Address - Street 2:
Practice Address - City:VERNON CENTER
Practice Address - State:MN
Practice Address - Zip Code:56090-1109
Practice Address - Country:US
Practice Address - Phone:507-549-3636
Practice Address - Fax:507-299-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)