Individual
JACKLYN ELENA LUGINBILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
18 W 15TH ST APT 206, MINNEAPOLIS, MN 55403-2424
(951) 533-2412
Mailing address
18 W 15TH ST APT 206, MINNEAPOLIS, MN 55403-2424
(951) 533-2412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
A507480700
MN
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A288173200
HENNEPIN COUNTY
MN
01
—
A405488800
SCOTT COUNTY
MN
01
—
A507480700
DHS
MN
Enumeration date
10/05/2017
Last updated
06/03/2024
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