Basic Information
| Provider Information | |||||||||
| NPI: | 1083909105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOLSEL | ||||||||
| FirstName: | TENZIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1919 UNIVERSITY AVE W STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551043435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512667876 | ||||||||
| FaxNumber: | 6512667850 | ||||||||
| Practice Location | |||||||||
| Address1: | 1919 UNIVERSITY AVE W STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551043435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512667876 | ||||||||
| FaxNumber: | 6512667850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2011 | ||||||||
| LastUpdateDate: | 07/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 25822 | MN | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YA0400X | 303022 | MN | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | 25822 | 01 | MN | LICENSED INDEPENDENT CLINICAL SOCIAL WORKER | OTHER | 303022 | 01 | MN | LICENSED ALCOHOL AND CRUG ABUSE COUNSELOR | OTHER |