Provider Demographics
NPI:1255116331
Name:PRAIRIE WINDS COUNSELING
Entity type:Organization
Organization Name:PRAIRIE WINDS COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ELLING PRZYBILLA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:507-944-1557
Mailing Address - Street 1:2257 110TH ST
Mailing Address - Street 2:
Mailing Address - City:BALATON
Mailing Address - State:MN
Mailing Address - Zip Code:56115-3120
Mailing Address - Country:US
Mailing Address - Phone:507-944-1557
Mailing Address - Fax:
Practice Address - Street 1:104 W REDWOOD ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1980
Practice Address - Country:US
Practice Address - Phone:507-944-1557
Practice Address - Fax:507-607-8717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty