| Organization Name: | DD OPATZ COUNSELING, LLC |
| NPI Number: | 1083979207 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE DOCKENDORF OPATZ (OWNER / SOLE MEMBER) |
| Mailing Address: | 3333 W. Division St. Ste 100 Midtown Square St. Cloud |
| State: | MN US |
| Postal Code: | 56303 |
| Phone Number: | 3203393226 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2012 |
| NPI Last Update Date: | 07/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1902 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |