Individual
MISS JILL MARIE STALOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
6245 W 214TH ST, JORDAN, MN 55352-8646
(612) 743-4663
Mailing address
6245 W 214TH ST, JORDAN, MN 55352-8646
(612) 743-4663
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
137856
IA
101YP2500X
Professional Counselor
12241-125
WI
101YP2500X
Professional Counselor
Primary
209
MN
Other
Enumeration date
12/05/2008
Last updated
04/17/2026
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