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Individual

LOREN BERGSTEDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LADC

Contact information

Practice address
11141 ZEALAND AVE N, CHAMPLIN, MN 55316
(651) 769-7607
(763) 951-3097
Mailing address
2807 BROOKDALE DR, BROOKLYN PARK, MN 55444-1844
(651) 348-5614
(763) 237-9898

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303764
MN
101YP2500X
Professional Counselor
Primary
CC00846
MN

Other

Enumeration date
05/10/2014
Last updated
07/10/2018
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