Healthcare Provider Details

I. General information

NPI: 1235047531
Provider Name (Legal Business Name): BPK PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2796 OXFORD ST N
ROSEVILLE MN
55113-2051
US

IV. Provider business mailing address

2796 OXFORD ST N
ROSEVILLE MN
55113-2051
US

V. Phone/Fax

Practice location:
  • Phone: 651-269-5454
  • Fax: 651-269-5454
Mailing address:
  • Phone: 651-269-5454
  • Fax: 651-269-5454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BELLE P KHUU
Title or Position: THERAPIST
Credential: PHD, LICSW
Phone: 651-269-5454