Provider Demographics
NPI:1740206994
Name:HOCKER, JOANNA SHAGER (MS, LP, LMFT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:SHAGER
Last Name:HOCKER
Suffix:
Gender:F
Credentials:MS, LP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2124
Mailing Address - Country:US
Mailing Address - Phone:507-526-4673
Mailing Address - Fax:
Practice Address - Street 1:516 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2124
Practice Address - Country:US
Practice Address - Phone:507-526-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0759103TC1900X
MN559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN114934OtherUCARE PROVIDER NUMBER
MN70094OtherMEDICA PROVIDER #
MN10998OtherMMSI (MAYO) PROVIDER #
MN84151SHOtherBC/BS PROVIDER #
MN19763OtherHEALTH PARTNERS