1831429620 NPI number — JESSICA MARIE VOERDING MA, LMFT

Table of content: JESSICA MARIE VOERDING MA, LMFT (NPI 1831429620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831429620 NPI number — JESSICA MARIE VOERDING MA, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOERDING
Provider First Name:
JESSICA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KATORSKI
Provider Other First Name:
JESSICA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831429620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1101 E 78TH ST
Provider Second Line Business Mailing Address:
SUITE 318
Provider Business Mailing Address City Name:
BLOOMINGTON
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55420-1400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-885-1268
Provider Business Mailing Address Fax Number:
952-884-9684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 E 78TH ST
Provider Second Line Business Practice Location Address:
SUITE 318
Provider Business Practice Location Address City Name:
BLOOMINGTON
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55420-1400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-885-1268
Provider Business Practice Location Address Fax Number:
952-884-9684
Provider Enumeration Date:
12/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  2040 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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