Provider Demographics
NPI:1558458562
Name:BJERKE, DUANE CLEABERT (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:CLEABERT
Last Name:BJERKE
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 BRUNSWICK AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-2485
Mailing Address - Country:US
Mailing Address - Phone:763-323-3375
Mailing Address - Fax:
Practice Address - Street 1:1201 89TH AVE NE
Practice Address - Street 2:SUITE 390
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3370
Practice Address - Country:US
Practice Address - Phone:612-879-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist