Provider Demographics
NPI:1821853896
Name:WORKMAN JESNESS, TODD (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:WORKMAN JESNESS
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2341
Mailing Address - Country:US
Mailing Address - Phone:954-547-3256
Mailing Address - Fax:
Practice Address - Street 1:3205 ROLLING HILLS DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2341
Practice Address - Country:US
Practice Address - Phone:954-547-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2814106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty