JACKIE HARRISON (NPI# 1902295306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902295306 |
Entity Type | Individual |
Full Name | JACKIE HARRISON |
Practice Address |
12708 Wayzata Blvd Suite 412 Minnetonka MN 55305-1916 |
Practice Telephone | 7634434562 |
Mailing Telephone | 7634434562 |
Enumeration Date | 2015-01-22 |
Last Update Date | 2015-07-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1796 | MN | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508334160 | Jackie Harrison | Registered Nurse | 2213 Cherry St, Toledo, OH 43608-2603 | 2018-11-12 |
Street Address |
12708 WAYZATA BLVD SUITE 412 |
City | MINNETONKA |
State | MN |
Zip Code | 55305-1916 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
Find all providers in zip 55305 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
1811469653 | Matthew Jon Thorson | Counselor | 11900 Wayzata Blvd Ste 100, Minnetonka, MN 55305-2018 | 2018-12-18 |
1801397302 | Fartun Ahmed | Counselor | 16020 Temple Dr, Minnetonka, MN 55345-3422 | 2018-02-21 |
1285098202 | Deborah Hagen | Counselor | 2601 Abbey Hill Dr, Minnetonka, MN 55305-2333 | 2016-04-06 |
1316314131 | Todd Wilson | Counselor | 5101 Boarshead Rd, Apt #117, Minnetonka, MN 55345-4042 | 2015-08-27 |
1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
1154603116 | Judy D Siems | Counselor | 1615 Archwood Rd, Minnetonka, MN 55305 | 2011-09-15 |
1265556203 | Odyssey Programs, LLC | Counselor | 14300 Cty Rd 62, Minnetonka, MN 55345 | 2007-03-16 |
1093856502 | Scott C Washburn | Counselor | 15320 Minnetonka Blvd #200, Minnetonka, MN 55345 | 2007-02-08 |
1407961709 | Cdc Centers | Counselor | 15612 Highway 7, Suite 150, Minnetonka, MN 55345-3543 | 2006-08-20 |
Find all providers in MINNETONKA |
City | MINNETONKA |
Zip Code | 55305 |
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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.