Julie Blaske, MA LADC LMFT
Individual provider Active NPI Marriage & Family Therapist · White Bear Lake, MN
NPI 1124486246 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124486246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 3106 (MN)
- Practice address
- 1310 Hwy 96 E
Suite 200
White Bear Lake, MN 55110 - Phone
- (612) 241-6004
- NPI assigned
- Feb 3, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303395 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 3106 | MN | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 303395 | MN | |
| Marriage & Family Therapist | 106H00000X | 3106 | MN | Yes |
Addresses
Primary practice location
1310 Hwy 96 E
Suite 200
White Bear Lake, MN 55110
Mailing address
3515 Tiffany Lane
Shoreview, MN 55126
Phone (651) 238-2840
Other practice location 1
620 Civic Heights Dr
Suite 103
Circle Pines, MN 55014-4711
Phone (651) 238-2840
Other providers in White Bear Lake, MN
- Birch Lake Dental PA
- Birch Lake Professional Counseling Group, Inc.
- Birch Lake Vision Group, LLC.
- Ami Bischel
- Rebecca Lynn Blaede
- Claire Bode
- Jennifer Elizabeth Boike Armerding
- Cristina Bommarito
- Sarah Elizabeth Boo
- Amy Spitzmueller Borash
All providers in White Bear Lake, MN · Marriage & Family Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.