| Lineage Counseling | |
|
4900 Highway 169 N Ste 115 New Hope MN 55428-4058 | |
| (612) 427-8197 | |
| Not Available |
| Full Name | Lineage Counseling |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4900 Highway 169 N Ste 115, New Hope, Minnesota |
| Authorized Official Name and Position | Rebekah Brandvold (OWNER) |
| Authorized Official Contact | 6127166795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lineage Counseling 2000 Shenandoah Ct Unit A Plymouth MN 55447-6420 Ph: (612) 716-6795 | Lineage Counseling 4900 Highway 169 N Ste 115 New Hope MN 55428-4058 Ph: (612) 427-8197 |
| NPI Number | 1669071528 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 10/21/2020 |
| Certification Date | 10/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669071528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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