Healthcare Provider Details

I. General information

NPI: 1326760299
Provider Name (Legal Business Name): ALICIA LYNN BJORKEDAL LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 W 109TH ST
BLOOMINGTON MN
55438-2374
US

IV. Provider business mailing address

7400 W 109TH ST
BLOOMINGTON MN
55438-2374
US

V. Phone/Fax

Practice location:
  • Phone: 612-223-8898
  • Fax:
Mailing address:
  • Phone: 612-223-8898
  • Fax: 833-972-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number04981
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: