Provider Demographics
NPI:1740673649
Name:HJELM, DANIELLE (MA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HJELM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9766 FALLON AVE NE STE 201
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-4589
Mailing Address - Country:US
Mailing Address - Phone:763-732-5541
Mailing Address - Fax:763-322-5026
Practice Address - Street 1:9766 FALLON AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362
Practice Address - Country:US
Practice Address - Phone:763-732-5541
Practice Address - Fax:763-322-5026
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077116101YM0800X
MNCC01931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health