Forward Bound Counseling PLLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Henderson, MN
NPI 1992428510 · NPPES record last updated Feb 27, 2024
Key facts
- NPI
- 1992428510
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- FORWARD BOUND COUNSELING PLLC
- Practice address
- 522 Main St
Henderson, MN 56044-7709 - Phone
- (507) 858-3019
- NPI assigned
- Sep 20, 2022
- Organization subpart
- No
Authorized official
- Name
- Emily Jean Christenson, LMFT
- Title
- Owner
- Phone
- (507) 858-3019
Practitioners 3
-
Sheila L Salo-Seifert, LMFT
-
Lynn O'Brien, EDD,LPCC-S,NCC,RPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240212002655 | MN | Part B Supplier - Clinic/Group Practice | 2163865619 |
Receives reassigned benefits from 3 practitioners Practice locations: Le Sueur, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
522 Main St
Henderson, MN 56044-7709
Mailing address
522 Main St
Henderson, MN 56044-7709
Phone (507) 858-3019
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7305651 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | emilym@forwardbound.org | Direct |
Other providers in Henderson, MN
- Erin Arnst
- Emily Jean Christenson
- Edvisions Cooperative, Inc.
- Edvisions Off Campus High School
- Health Ride Inc
- Henderson Healing Hub, LLC
- Jennifer L Kolter
- Minnesota New Country School
- Sibley Medical Center
All providers in Henderson, MN · Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.