Healthcare Provider Details

I. General information

NPI: 1588092886
Provider Name (Legal Business Name): MEGAN MCMANUS BJORKLUND LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN MCMANUS

II. Dates (important events)

Enumeration Date: 10/23/2013
Last Update Date: 07/04/2020
Certification Date: 07/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 SHELARD PKWY STE 110
PLYMOUTH MN
55441-6451
US

IV. Provider business mailing address

9800 SHELARD PKWY STE 110
PLYMOUTH MN
55441-6451
US

V. Phone/Fax

Practice location:
  • Phone: 612-298-7131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2064
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: