Provider Demographics
NPI:1184722241
Name:HARSTE, JOANNE MARIE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:MARIE
Last Name:HARSTE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20083 226TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309
Mailing Address - Country:US
Mailing Address - Phone:651-353-5453
Mailing Address - Fax:
Practice Address - Street 1:20083 226TH AVE NW
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309
Practice Address - Country:US
Practice Address - Phone:651-353-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN106623400OtherMEDICAL ASSISTANCE
MN381R1HAMedicare UPIN
MN106623400OtherMEDICAL ASSISTANCE
MN62-93125Medicare UPIN
MNXXXXX0655Medicare UPIN