Provider Demographics
NPI:1467999136
Name:HEARTLAND COUNSELING, LLC
Entity Type:Organization
Organization Name:HEARTLAND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-636-1107
Mailing Address - Street 1:190 S RIVER RIDGE CIR
Mailing Address - Street 2:SUITE209
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1627
Mailing Address - Country:US
Mailing Address - Phone:952-736-8393
Mailing Address - Fax:952-736-8375
Practice Address - Street 1:190 S RIVER RIDGE CIR
Practice Address - Street 2:SUITE209
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1627
Practice Address - Country:US
Practice Address - Phone:952-736-8393
Practice Address - Fax:952-736-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1251106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1275593949OtherINDIVIDUAL NPI NUMBER