Healthcare Provider Details

I. General information

NPI: 1376454736
Provider Name (Legal Business Name): JOSHUA PILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 165TH ST W
LAKEVILLE MN
55044-5729
US

IV. Provider business mailing address

10535 165TH ST W
LAKEVILLE MN
55044-5729
US

V. Phone/Fax

Practice location:
  • Phone: 952-435-0022
  • Fax:
Mailing address:
  • Phone: 952-435-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5846
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: