| Forward Bound Counseling Pllc | |
|
522 Main St Henderson MN 56044-7709 | |
| (507) 858-3019 | |
| Not Available |
| Full Name | Forward Bound Counseling Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 522 Main St, Henderson, Minnesota |
| Authorized Official Name and Position | Emily Jean Christenson (OWNER) |
| Authorized Official Contact | 5078583019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forward Bound Counseling Pllc 522 Main St Henderson MN 56044-7709 Ph: (507) 858-3019 | Forward Bound Counseling Pllc 522 Main St Henderson MN 56044-7709 Ph: (507) 858-3019 |
| NPI Number | 1992428510 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 2163865619 |
|---|---|
| Medicare Enrollment ID | O20240212002655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992428510 | NPI | - | NPPES |
| 7305651 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Emily Jean Christenson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356844203 PECOS PAC ID: 3072956523 Enrollment ID: I20240212002770 |
| Provider Name | Sheila L Salo-seifert |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1588128136 PECOS PAC ID: 6305280538 Enrollment ID: I20240215003172 |
| Provider Name | Lynn O'brien |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205694825 PECOS PAC ID: 1557897097 Enrollment ID: I20241209000549 |