Organization
PARKDALE THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LAMONT JANKORD LMFT (CEO)
(952) 224-0399
Entity
Organization
Contact information
Practice address
1000 SHELARD PKWY STE 520, ST LOUIS PARK, MN 55426-1053
(952) 224-0399
(952) 224-0396
Mailing address
1000 SHELARD PKWY STE 520, ST LOUIS PARK, MN 55426-1053
(952) 224-0399
(952) 224-0396
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301574
MN
101YP2500X
Professional Counselor
00054
MN
103TP0016X
Prescribing (Medical) Psychologist
27774
MN
106H00000X
Marriage & Family Therapist
1023
MN
106H00000X
Marriage & Family Therapist
Primary
1044
MN
Other
Enumeration date
07/31/2007
Last updated
08/03/2020
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