Healthcare Provider Details

I. General information

NPI: 1982561981
Provider Name (Legal Business Name): JOAN GENEVIEVE BOEVERS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GLENWOOD AVE
MINNEAPOLIS MN
55405-1430
US

IV. Provider business mailing address

1611 COUNTY ROAD B W STE 312
ROSEVILLE MN
55113-4107
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-1454
  • Fax: 612-871-1505
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5394
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: