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General NPI Number Information
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NPI Number | 1558644633
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Entity Type | Organization
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Legal Business Name | JOINING HANDS CHILD AND FAMILY COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 09/24/2011
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Last Update Date | 09/24/2011
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Provider Practice Location Address
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Address Line | 1711 COUNTY ROAD B W STE 113S
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City | ROSEVILLE
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State | MN
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Zip | 55113-4000
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Country | US
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Telephone | 651-528-8587
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 COUNTY ROAD B W STE 113S
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City | ROSEVILLE
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State | MN
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Zip | 55113-4000
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Country | US
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Telephone | 651-528-8587
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KATHLEEN KANE
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Credential | LICSW
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Telephone | 651-528-8587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 16545
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License Number State | MN
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