Egertson, Samuel Joseph

Egertson, Samuel Joseph is an individual health care provider with primary practice located at 5407 Excelsior Blvd Ste B , St Louis Park MN 55416-2932. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Egertson, Samuel Joseph can be contacted via phone (612) 787-2832.

Contact Information

Primary practice address
5407 Excelsior Blvd Ste B St Louis Park MN 55416-2932
Phone: (612) 787-2832
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 2018038889 Missouri
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X Minnesota

Profile Details

NPI number 1053885756
LBN Legal business name Egertson, Samuel Joseph
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2019
Last updated Jun 15th, 2021 - about 5 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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