Provider Demographics
NPI:1649815614
Name:SUMMER COUNSELING AND BEHAVIORAL HEALTH SUMMER COUNSELING
Entity type:Organization
Organization Name:SUMMER COUNSELING AND BEHAVIORAL HEALTH SUMMER COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUMMER
Authorized Official - Last Name:KOKES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:651-327-0849
Mailing Address - Street 1:1687 WOODLANE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3047
Mailing Address - Country:US
Mailing Address - Phone:651-327-0849
Mailing Address - Fax:
Practice Address - Street 1:1687 WOODLANE DR STE 208
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3047
Practice Address - Country:US
Practice Address - Phone:651-327-0849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty