Provider Demographics
NPI:1710250832
Name:HAUSE, JOAN D (LPCC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:D
Last Name:HAUSE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2388 UNIVERSITY AVE W STE 202
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1769
Mailing Address - Country:US
Mailing Address - Phone:612-293-5124
Mailing Address - Fax:651-300-2702
Practice Address - Street 1:2388 UNIVERSITY AVE W STE 202
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1769
Practice Address - Country:US
Practice Address - Phone:612-293-5124
Practice Address - Fax:651-300-2702
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01153101YP2500X
MNLPC #01153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional