Provider Demographics
NPI:1497539092
Name:PRENOSIL, JOSEPH FRANCIS V (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:PRENOSIL
Suffix:V
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1784 132ND LN NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4138
Mailing Address - Country:US
Mailing Address - Phone:651-755-1342
Mailing Address - Fax:
Practice Address - Street 1:1784 132ND LN NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4138
Practice Address - Country:US
Practice Address - Phone:651-755-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health