Provider Demographics
NPI:1902437627
Name:NORD, JOHN ROBERT (MA-PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:NORD
Suffix:
Gender:M
Credentials:MA-PSYCHOTHERAPIST
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:ROBERT
Other - Last Name:NORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JOHN R NORD
Mailing Address - Street 1:939 HUNTINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-4531
Mailing Address - Country:US
Mailing Address - Phone:612-790-6673
Mailing Address - Fax:
Practice Address - Street 1:10505 WAYZATA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1507
Practice Address - Country:US
Practice Address - Phone:612-790-6673
Practice Address - Fax:952-582-1666
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional