Provider Demographics
NPI:1366680050
Name:CLAPSADDLE, JEANINE RUTH (MA, LAMFT)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:RUTH
Last Name:CLAPSADDLE
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 MAYVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5937
Mailing Address - Country:US
Mailing Address - Phone:612-910-6010
Mailing Address - Fax:925-920-9323
Practice Address - Street 1:5407 EXCELSIOR BLVD. SUITE B
Practice Address - Street 2:
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-910-6010
Practice Address - Fax:952-920-9323
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1803106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist