PARKDALE THERAPY GROUP, LLC (NPI# 1275723777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275723777 |
| Entity Type | Organization |
| Organization Name | PARKDALE THERAPY GROUP, LLC |
| Practice Address |
1000 Shelard Pkwy Ste 520 St Louis Park MN 55426-1053 |
| Practice Telephone | 9522240399 |
| Practice Fax Number | 9522240396 |
| Mailing Telephone | 9522240399 |
| Mailing Fax Number | 9522240396 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | JOHN LAMONT JANKORD (CEO) |
| Authorized Official Telephone | 9522240399 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
301574 | MN | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
00054 | MN | Behavioral Health & Social Service Providers |
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
27774 | MN | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 1023 | MN | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | 1044 | MN | Behavioral Health & Social Service Providers |
| Street Address |
1000 SHELARD PKWY STE 520 |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-1053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942854252 | Emilee Marie Rodriguez | Marriage & Family Therapist | 1000 Shelard Pkwy Ste 220, St Louis Park, MN 55426-4911 | 2019-07-25 |
| 1609434174 | Efren Francisco Solanas | Marriage & Family Therapist | 5407 Excelsior Blvd Ste A, St Louis Park, MN 55416-2932 | 2019-05-30 |
| 1568984987 | Kathryn Kadleck | Marriage & Family Therapist | 5407 Excelsior Blvd Ste Ab&e, St Louis Park, MN 55416-2929 | 2017-07-07 |
| 1275076564 | Aria Counseling, LLC | Marriage & Family Therapist | 6524 Walker St, Suite 209, St Louis Park, MN 55426-4238 | 2016-11-18 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1649635749 | Rachel Ellen Miller Jacobsen | Marriage & Family Therapist | 6524 Walker St Ste 209, St Louis Park, MN 55426-4245 | 2015-12-16 |
| 1295072783 | Angela Josefina Mendez | Marriage & Family Therapist | 4725 Minnetonka Blvd, Apt 102, St Louis Park, MN 55416-5711 | 2013-01-03 |
| 1831478700 | Jeffrey Marc Rosenfeld | Marriage & Family Therapist | 4730 Park Commons Dr Unit 407, St Louis Park, MN 55416-5219 | 2011-08-10 |
| 1457512196 | Molly Charlotte Abeln | Marriage & Family Therapist | 5354 Parkdale Dr Fl 2, St Louis Park, MN 55416-1603 | 2008-06-24 |
| 1891988234 | Molly Tannuzzo | Marriage & Family Therapist | 715 Florida Ave S Ste 307, St Louis Park, MN 55426-1759 | 2007-08-20 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
Please comment or provide details below to improve the information on PARKDALE THERAPY GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.