Bakken, Joel T

Bakken, Joel T is an individual health care provider with primary practice located at 1547 30Th Ave S , Moorhead MN 56560-5149. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Bakken, Joel T can be contacted via phone (218) 287-4338.

Contact Information

Primary practice address
1547 30Th Ave S Moorhead MN 56560-5149
Phone: (218) 287-4338
Fax: (218) 287-5928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP0872 Minnesota

Profile Details

NPI number 1497849509
LBN Legal business name Bakken, Joel T
Credentials MS LP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated May 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497849509 NPPES
Minnesota Other 140L6BA BLUE CROSS
Minnesota MEDICAID 448852100 BLUE CROSS

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