Bostrom, Jared Brent
Bostrom, Jared Brent is an individual health care provider with primary practice located at 1100 E 80Th St , Bloomington MN 55420-1426. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Bostrom, Jared Brent can be contacted via phone (952) 956-3101.Contact Information
Primary practice address
1100 E 80Th St
Bloomington MN 55420-1426
Phone: (952) 956-3101
Fax: (952) 564-3031
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 4866770 | Minnesota |
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 303234 | Minnesota |
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 2913 | Minnesota |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 4866770 | Minnesota |
Profile Details
NPI number | 1427329143 |
---|---|
LBN Legal business name | Bostrom, Jared Brent |
Credentials | LMFT, LADC, CPRP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 26th, 2012 |
Last updated | Nov 22nd, 2019 - about 6 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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