Healthcare Provider Details

I. General information

NPI: 1891371050
Provider Name (Legal Business Name): JUNIPER COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3387 BROWNLOW AVE STE 110
ST LOUIS PARK MN
55426-4271
US

IV. Provider business mailing address

3817 MAIN ST
ST BONIFACIUS MN
55375-1134
US

V. Phone/Fax

Practice location:
  • Phone: 612-416-4384
  • Fax:
Mailing address:
  • Phone: 608-658-2668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MADELINE FALK
Title or Position: OWNER
Credential: LMFT
Phone: 608-656-2668