# RUM RIVER COUNSELING, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073578472
- **Authorized official:** JENNIFER HOLDREDGE M.A., L.M.F.T. (OWNER)
- **Authorized official phone:** (763) 482-9598

## Contact information

- **Practice address:** 1875 STATION PKWY NW STE 100, ANDOVER, MN 55304-3319
- **Practice address phone:** (763) 482-9598
- **Practice address fax:** (612) 235-6447
- **Mailing address:** 1875 STATION PKWY NW STE A, ANDOVER, MN 55304-3318
- **Mailing address phone:** (612) 382-0032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 06/12/2023