Organization
RUM RIVER COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HOLDREDGE M.A., L.M.F.T. (OWNER)
(763) 482-9598
Entity
Organization
Contact information
Practice address
1875 STATION PKWY NW STE 100, ANDOVER, MN 55304-3319
(763) 482-9598
(612) 235-6447
Mailing address
1875 STATION PKWY NW STE A, ANDOVER, MN 55304-3318
(612) 382-0032
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053N2RU
BLUE CROSS BLUE SHIELD
MN
01
—
102200
HEALTHPARTNERS
MN
01
—
178H8RU
BLUE CROSS BLUE SHIELD
MN
01
—
190G6RU
BLUE CROSS BLUE SHIELD
MN
05
—
827933000
—
MN
Enumeration date
04/19/2006
Last updated
06/12/2023
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