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General NPI Number Information
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NPI Number | 1730076811
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Entity Type | Organization
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Legal Business Name | JOCELYN THOEMKE LLC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 2637 27TH AVE S STE 240
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-3197
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Country | US
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Telephone | 612-758-0155
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Fax | 612-416-8167
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Provider Business Mailing Address
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Address Line | 1795 TATUM ST
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City | SAINT PAUL
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State | MN
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Zip | 55113-5525
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Country | US
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Telephone | 651-214-0715
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOCELYN ROSE THOEMKE
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Credential | LMFT
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Telephone | 651-214-0715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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