Provider Demographics
NPI:1194184465
Name:CHJL LLC
Entity Type:Organization
Organization Name:CHJL LLC
Other - Org Name:BE. COUNSELING PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:PHELPS
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-251-4753
Mailing Address - Street 1:8120 PENN AVE S STE. 252
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:612-251-4753
Mailing Address - Fax:651-730-6657
Practice Address - Street 1:8120 PENN AVE S STE 252
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1358
Practice Address - Country:US
Practice Address - Phone:612-251-4753
Practice Address - Fax:651-730-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00282101YP2500X
MN4714103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty