1659754240 NPI number — YAEKEL-BLACK ELK COUNSELING & CONSULTING

Table of content: MRS. DANIELLE NICOLE STRAHAN PMHNP (NPI 1053133348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659754240 NPI number — YAEKEL-BLACK ELK COUNSELING & CONSULTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YAEKEL-BLACK ELK COUNSELING & CONSULTING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659754240
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
49659 STATE LINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANDSTONE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55072-3032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-590-1932
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
49659 STATE LINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANDSTONE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55072-3032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-590-1932
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2015

Additional Information

Authorized Official

Authorized Official Last Name:
YAEKEL-BLACK ELK
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
COUNSELOR/CONSULTANT
Authorized Official Telephone Number:
218-590-1932

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  3776-125 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: CC00588 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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