# PARKDALE THERAPY GROUP, LLC

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

## Provider details

- **NPI number:** 1275723777
- **Authorized official:** JOHN LAMONT JANKORD LMFT (CEO)
- **Authorized official phone:** (952) 224-0399

## Contact information

- **Practice address:** 1000 SHELARD PKWY STE 520, ST LOUIS PARK, MN 55426-1053
- **Practice address phone:** (952) 224-0399
- **Practice address fax:** (952) 224-0396
- **Mailing address:** 1000 SHELARD PKWY STE 520, ST LOUIS PARK, MN 55426-1053
- **Mailing address phone:** (952) 224-0399
- **Mailing address fax:** (952) 224-0396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 301574 | MN | — |
| 101YP2500X | Professional Counselor | 00054 | MN | — |
| 103TP0016X | Prescribing (Medical) Psychologist | 27774 | MN | — |
| 106H00000X | Marriage & Family Therapist | 1023 | MN | — |
| 106H00000X | Marriage & Family Therapist | 1044 | MN | Yes |

## Other

- **Enumeration date:** 07/31/2007
- **Last updated:** 08/03/2020