Provider Demographics
NPI:1144690215
Name:JADE COUNSELING LLC
Entity type:Organization
Organization Name:JADE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-327-7999
Mailing Address - Street 1:4721 BRYANT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5356
Mailing Address - Country:US
Mailing Address - Phone:612-327-7999
Mailing Address - Fax:
Practice Address - Street 1:600 W 78TH ST STE 220A
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9585
Practice Address - Country:US
Practice Address - Phone:612-327-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN163081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty