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Organization

JOEL GROSTEPHAN, LICSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOEL PAUL GROSTEPHAN LICSW (THERAPIST/OWNER)
(612) 839-5853
Entity
Organization

Contact information

Practice address
3011 36TH AVE S STE 10, MINNEAPOLIS, MN 55406-2800
(612) 839-5853
Mailing address
3011 36TH AVE. S., #10, MINNEAPOLIS, MN 55406
(612) 839-5853

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
20930
MN

Other

Enumeration date
10/05/2015
Last updated
10/05/2015
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