Provider Demographics
NPI:1326610163
Name:BJERKE, JULIE LOIS
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LOIS
Last Name:BJERKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 COMMERCIAL AVE N
Mailing Address - Street 2:
Mailing Address - City:SANDSTONE
Mailing Address - State:MN
Mailing Address - Zip Code:55072-4412
Mailing Address - Country:US
Mailing Address - Phone:320-245-9966
Mailing Address - Fax:
Practice Address - Street 1:413 COMMERCIAL AVE N
Practice Address - Street 2:
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072-4412
Practice Address - Country:US
Practice Address - Phone:320-245-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305901101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)