Berndt, Jerome C

Berndt, Jerome C is an individual health care provider with primary practice located at 215 Se 2Nd Ave , Grand Rapids MN 55744-3615. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Berndt, Jerome C can be contacted via phone (218) 326-1274.

Contact Information

Primary practice address
215 Se 2Nd Ave Grand Rapids MN 55744-3615
Phone: (218) 326-1274
Fax: (218) 326-8255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 00563 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 36 Minnesota

Profile Details

NPI number 1770705337
LBN Legal business name Berndt, Jerome C
Credentials LICSW & LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated May 20th, 2008 - about 17 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 1770705337 NPPES
Minnesota MEDICAID 70235700
Minnesota Other 62-20162
Minnesota Other 1009418
Minnesota Other 69264BE

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