Kortgard, Jennifer Joy

Kortgard, Jennifer Joy is an sole proprietor health care provider with primary practice located at 1919 University Ave W Ste 200 , Saint Paul MN 55104-3435. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kortgard, Jennifer Joy can be contacted via phone (651) 266-7999.

Contact Information

Primary practice address
1919 University Ave W Ste 200 Saint Paul MN 55104-3435
Phone: (651) 266-7999
Fax: (651) 266-7850
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 21266 Minnesota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 21266 Minnesota

Profile Details

NPI number 1376911362
LBN Legal business name Kortgard, Jennifer Joy
Credentials LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2015
Last updated Sep 1st, 2023 - about 3 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 1376911362 NPPES
Minnesota MEDICAID 1255805800

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