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General NPI Number Information
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NPI Number | 1720979909
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Entity Type | Organization
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Legal Business Name | STRAIGHT RIVER COUNSELING LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 245 18TH ST SE STE 102
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City | OWATONNA
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State | MN
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Zip | 55060-4062
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Country | US
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Telephone | 507-200-8330
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Fax |
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Provider Business Mailing Address
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Address Line | 636 12TH ST SE
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City | OWATONNA
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State | MN
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Zip | 55060-4109
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Country | US
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Telephone | 507-200-8330
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | MRS. JESSICA JOY BORKENHAGEN
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Credential | BA, MS, LPCC
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Telephone | 507-200-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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