Provider Demographics
NPI:1558946574
Name:HOUK, JAMIE (MA, LPCC)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:HOUK
Suffix:
Gender:F
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 1:17685 JUNIPER PATH STE 301
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-9821
Mailing Address - Country:US
Mailing Address - Phone:952-214-8959
Mailing Address - Fax:
Practice Address - Street 1:17685 JUNIPER PATH
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-9819
Practice Address - Country:US
Practice Address - Phone:952-214-8959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional