Provider Demographics
NPI:1457953655
Name:OAKHEART THERAPY, PLLC
Entity type:Organization
Organization Name:OAKHEART THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEDINAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-408-7975
Mailing Address - Street 1:7195 NE 301 RD
Mailing Address - Street 2:
Mailing Address - City:LOWRY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64763-9207
Mailing Address - Country:US
Mailing Address - Phone:612-408-7975
Mailing Address - Fax:
Practice Address - Street 1:7211 NE 301 RD
Practice Address - Street 2:
Practice Address - City:LOWRY CITY
Practice Address - State:MO
Practice Address - Zip Code:64763-6476
Practice Address - Country:US
Practice Address - Phone:612-408-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty