Bacon, Jane Galvin

Bacon, Jane Galvin is an individual health care provider with primary practice located at 1280 North Birch Lake Blvd White Bear Lake Area Community Counseling Center, White Bear Lake MN 55110-6708. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bacon, Jane Galvin can be contacted via phone (651) 429-8544.

Contact Information

Primary practice address
1280 North Birch Lake Blvd White Bear Lake Area Community Counseling Center White Bear Lake MN 55110-6708
Phone: (651) 429-8544
Fax: (651) 407-5301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP2821 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 320 Minnesota

Profile Details

NPI number 1801968094
LBN Legal business name Bacon, Jane Galvin
Credentials MA LP LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801968094 NPPES
Minnesota Other 56963BA BLUE CROSS BLUE SHIELD
Minnesota Other 103010 BLUE CROSS BLUE SHIELD
Minnesota Other 30119 BLUE CROSS BLUE SHIELD

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