MEDICARE: DR. COURTNEY PADJEN PHD, LAMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1366161697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COURTNEY PADJEN PHD, LAMFT

Provider Business Mailing Address
First Line	:	2900 BRYANT AVE S APT 306
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2126
Country	:	US
Telephone Number	:	715-864-2863
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 BRYANT AVE S APT 306
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2126
Country	:	US
Telephone Number	:	715-864-2863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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