Individual
CHAD MICHAEL JAYASEKERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LICSW
Contact information
Practice address
1645 106TH LN NW, COON RAPIDS, MN 55433-4278
(651) 210-5370
Mailing address
1645 106TH LN NW, COON RAPIDS, MN 55433-4278
(651) 210-5370
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24240
MN
106H00000X
Marriage & Family Therapist
2132
MN
Other
Enumeration date
12/29/2011
Last updated
05/01/2024
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