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General NPI Number Information
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NPI Number | 1649715400
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Entity Type | Organization
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Legal Business Name | TRUE NORTH THERAPY LLC
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 10591 165TH ST W
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City | LAKEVILLE
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State | MN
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Zip | 55044-3528
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Country | US
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Telephone | 952-300-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 864 STONE CREEK DR
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City | JORDAN
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State | MN
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Zip | 55352-4548
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Country | US
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Telephone | 952-300-1039
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JAIME MCNATT-SERBUS
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Credential | LICSW
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Telephone | 952-300-1039
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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 | 16509
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License Number State |
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