Provider Demographics
NPI:1083287429
Name:COURAGE AND GRIT COUNSELING LLC
Entity Type:Organization
Organization Name:COURAGE AND GRIT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-280-6326
Mailing Address - Street 1:601 CENTRAL AVE W.
Mailing Address - Street 2:SUITE #103 #108
Mailing Address - City:ST. MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376
Mailing Address - Country:US
Mailing Address - Phone:612-208-8540
Mailing Address - Fax:
Practice Address - Street 1:601 CENTRAL AVE W.
Practice Address - Street 2:SUITE #103 #108
Practice Address - City:ST. MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376
Practice Address - Country:US
Practice Address - Phone:612-208-8540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty