Provider Demographics
NPI:1912162413
Name:STAPEL, JEREMY JAMES (MA)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:JAMES
Last Name:STAPEL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7945 STONE CREEK DR STE 140
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4606
Mailing Address - Country:US
Mailing Address - Phone:952-974-3999
Mailing Address - Fax:952-974-3780
Practice Address - Street 1:7945 STONE CREEK DR STE 140
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317
Practice Address - Country:US
Practice Address - Phone:952-974-3999
Practice Address - Fax:952-974-3780
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health