Organization
BIRCH LAKE PROFESSIONAL COUNSELING GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE WILLIAM GLADDEN II PH.D. LPC, LMHC (MANAGING DIRECTOR)
(651) 653-1925
Entity
Organization
Contact information
Practice address
1310 HIGHWAY 96 E, SUITE 104B, WHITE BEAR LAKE, MN 55110-3624
(651) 653-1925
(651) 653-1956
Mailing address
1310 HIGHWAY 96 E, SUITE 104B, WHITE BEAR LAKE, MN 55110-3624
(651) 653-1925
(651) 653-1956
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00133
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00133
LPC
MN
Enumeration date
04/24/2007
Last updated
08/22/2020
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