Provider Demographics
NPI:1679140685
Name:THERAPY BY JOANN, PLLC
Entity Type:Organization
Organization Name:THERAPY BY JOANN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:701-740-4387
Mailing Address - Street 1:PO BOX 14422
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58208-4422
Mailing Address - Country:US
Mailing Address - Phone:701-738-9245
Mailing Address - Fax:
Practice Address - Street 1:4399 S COLUMBIA RD STE 104
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-2833
Practice Address - Country:US
Practice Address - Phone:701-738-9245
Practice Address - Fax:701-335-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty