Jackson, Julie

Jackson, Julie is an individual health care provider with primary practice located at 1385 Mendota Heights Rd Ste 200 , Mendota Heights MN 55120-1289. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jackson, Julie can be contacted via phone (651) 379-9800.

Contact Information

Primary practice address
1385 Mendota Heights Rd Ste 200 Mendota Heights MN 55120-1289
Phone: (651) 379-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CC01638 Minnesota

Profile Details

NPI number 1427561455
LBN Legal business name Jackson, Julie
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2017
Last updated Jun 16th, 2018 - about 8 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 1427561455 NPPES
Minnesota Other CC01638 INSURANCE PROVIDERS
Minnesota MEDICAID CC01638 INSURANCE PROVIDERS

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