| Krisma Counseling Inc. | |
|
112 W 1st St Suite 104 Fairmont MN 56031-1743 | |
| (507) 399-2149 | |
| (507) 399-2159 |
| Full Name | Krisma Counseling Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 112 W 1st St, Fairmont, Minnesota |
| Authorized Official Name and Position | Maurice Lee Shoen (CO-OWMER) |
| Authorized Official Contact | 5073992149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krisma Counseling Inc. 112 W 1st St Suite 104 Fairmont MN 56031-1743 Ph: (507) 399-2149 | Krisma Counseling Inc. 112 W 1st St Suite 104 Fairmont MN 56031-1743 Ph: (507) 399-2149 |
| NPI Number | 1477829737 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477829737 | NPI | - | NPPES |
| 6574051 | Medicaid | MN | |
| 1DH74KR | Other | MN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17553 (Minnesota) | Primary |
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