Kodet, Jonathan

Kodet, Jonathan is an individual health care provider with primary practice located at 1850 W Wayzata Blvd # 220 , Long Lake MN 55356-4413. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Counseling is his primary health care specialty. Kodet, Jonathan can be contacted via phone (612) 520-1244.

Contact Information

Primary practice address
1850 W Wayzata Blvd # 220 Long Lake MN 55356-4413
Phone: (612) 520-1244
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 6186 Minnesota
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6186 Minnesota

Profile Details

NPI number 1750838181
LBN Legal business name Kodet, Jonathan
Credentials PHD,LP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2016
Last updated Mar 27th, 2023 - 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 1750838181 NPPES
Minnesota MEDICAID 103TC0700X

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