Basic Information
| Provider Information | |||||||||
| NPI: | 1720461668 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WITMER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | NORTHSTAR REGIONAL COUNSELING | ||||||||
| Address2: | 7945 STONE CREEK DRIVE SUITE 140 | ||||||||
| City: | CHANHASSEN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529743999 | ||||||||
| FaxNumber: | 3202862875 | ||||||||
| Practice Location | |||||||||
| Address1: | NORTHSTAR REGIONAL COUNSELING | ||||||||
| Address2: | 7945 STONE CREEK DRIVE SUITE 140 | ||||||||
| City: | CHANHASSEN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529743999 | ||||||||
| FaxNumber: | 3202862875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2015 | ||||||||
| LastUpdateDate: | 10/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 01682 | MN | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | CC01973 | MN | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.