Provider Demographics
NPI:1184149429
Name:STORY, BILLIE JO (LPCC)
Entity type:Individual
Prefix:
First Name:BILLIE JO
Middle Name:
Last Name:STORY
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 1:130 WABASHA ST S STE 90
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1819
Mailing Address - Country:US
Mailing Address - Phone:651-450-2220
Mailing Address - Fax:651-450-2221
Practice Address - Street 1:318 2ND ST N
Practice Address - Street 2:
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-2014
Practice Address - Country:US
Practice Address - Phone:651-455-6800
Practice Address - Fax:651-306-1045
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1542OtherLPCC