Provider Demographics
NPI:1154761633
Name:BUDGE, JEAN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:BUDGE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12750 NICOLLET AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4468
Mailing Address - Country:US
Mailing Address - Phone:612-437-0910
Mailing Address - Fax:651-493-1105
Practice Address - Street 1:12750 NICOLLET AVE STE 215
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4468
Practice Address - Country:US
Practice Address - Phone:612-470-4129
Practice Address - Fax:651-493-1105
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist