Individual
BERNIE JEROME MENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA. LMFT
Contact information
Practice address
1303 S FRONTAGE RD STE 275, HASTINGS, MN 55033
(651) 319-6484
(651) 925-0442
Mailing address
1303 S FRONTAGE RD STE 275, HASTINGS, MN 55033-2655
(651) 319-6484
(651) 925-0442
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
3335
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113449046
—
MN
05
—
1790212926
—
MN
Enumeration date
01/18/2012
Last updated
06/11/2019
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