Jorenby, Charles Howard

Jorenby, Charles Howard is an individual health care provider with primary practice located at 6885 Boudin St Ne Ste 200 , Prior Lake MN 55372-2091. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Jorenby, Charles Howard can be contacted via phone (952) 226-2641.

Contact Information

Primary practice address
6885 Boudin St Ne Ste 200 Prior Lake MN 55372-2091
Fax: (952) 226-2741
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP3631 Minnesota

Profile Details

NPI number 1013999671
LBN Legal business name Jorenby, Charles Howard
Credentials MA, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Jul 23rd, 2019 - about 5 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 1013999671 NPPES
Minnesota MEDICAID 509108000
Minnesota Other 62-39496
Minnesota Other 792566000
Minnesota Other LP3631
Minnesota Other 2128297
Minnesota Other 437R8JO
Minnesota Other 437R7LI

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