Healthcare Provider Details

I. General information

NPI: 1275213381
Provider Name (Legal Business Name): JASON LEROY SCHAAL MA, LADC, ADC-MN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7767 ELM CREEK BLVD N STE 220
MAPLE GROVE MN
55369-7067
US

IV. Provider business mailing address

7767 ELM CREEK BLVD N STE 220
MAPLE GROVE MN
55369-7067
US

V. Phone/Fax

Practice location:
  • Phone: 763-445-9023
  • Fax:
Mailing address:
  • Phone: 763-445-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306673
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: