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General NPI Number Information
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NPI Number | 1467999136
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Entity Type | Organization
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Legal Business Name | HEARTLAND COUNSELING, LLC
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 11990 PORTLAND AVE
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City | BURNSVILLE
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State | MN
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Zip | 55337-1516
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Country | US
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Telephone | 952-736-8393
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Fax | 952-479-7896
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Provider Business Mailing Address
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Address Line | 11990 PORTLAND AVE
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City | BURNSVILLE
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State | MN
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Zip | 55337-1516
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Country | US
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Telephone | 952-736-8393
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Fax | 952-479-7896
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Authorized Official
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Title or Position | OWNER
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Name | SHARON JOYCE PETERSEN
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Credential | LMFT
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Telephone | 612-636-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1251
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License Number State | MN
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