Provider Demographics
NPI:1013210558
Name:BISCHOFF, JENNIFER MARY (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARY
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 2ND AVE S STE 160
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-1425
Mailing Address - Country:US
Mailing Address - Phone:320-425-0300
Mailing Address - Fax:320-425-0400
Practice Address - Street 1:2 2ND AVE S STE 160
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-1425
Practice Address - Country:US
Practice Address - Phone:320-425-0300
Practice Address - Fax:320-425-0400
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1969106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist