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General NPI Number Information
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NPI Number | 1922930833
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Entity Type | Organization
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Legal Business Name | ENDEAVOR INTEGRATIVE THERAPY, LLC
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 4604 ATLAS PL
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City | WOODBURY
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State | MN
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Zip | 55129-4429
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Country | US
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Telephone | 651-390-5453
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Fax |
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Provider Business Mailing Address
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Address Line | 4604 ATLAS PL
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City | WOODBURY
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State | MN
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Zip | 55129-4429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | JOSEPH KROHN
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Credential | LPCC, LADC
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Telephone | 651-390-5453
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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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