Healthcare Provider Details

I. General information

NPI: 1639095870
Provider Name (Legal Business Name): JILL HASBARGEN THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1576 TOWN ROAD 124
BIRCHDALE MN
56623-2733
US

IV. Provider business mailing address

1576 TOWN ROAD 124
BIRCHDALE MN
56623-2733
US

V. Phone/Fax

Practice location:
  • Phone: 218-308-9709
  • Fax:
Mailing address:
  • Phone: 218-308-9709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JILL CARRIE HASBARGEN
Title or Position: OWNER/THERAPIST
Credential: LMFT
Phone: 218-434-0980