Healthcare Provider Details

I. General information

NPI: 1467034470
Provider Name (Legal Business Name): COURTNEY E BJORKLUND LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HARDING ST NE STE 100
MINNEAPOLIS MN
55413-2801
US

IV. Provider business mailing address

401 HARDING ST NE STE 100
MINNEAPOLIS MN
55413-2801
US

V. Phone/Fax

Practice location:
  • Phone: 612-398-7000
  • Fax:
Mailing address:
  • Phone: 612-398-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26024
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: