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Organization

STRENGTHEN SOCIAL SKILLS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOAN BLACKMAN MA, LICSW (PEERS INSTRUCTOR)
(952) 393-9884
Entity
Organization

Contact information

Practice address
20 NORTHDALE BLVD NW, COON RAPIDS, MN 55448-3356
(952) 393-9884
Mailing address
313 MADISON AVE S, HOPKINS, MN 55343-8446
(952) 393-9884

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1083846711
NPI
01
1720385735
NPI
Enumeration date
10/16/2024
Last updated
10/16/2024
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