Provider Demographics
NPI:1558169185
Name:JORGENSON, EMILY (LPCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:JORGENSON
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8917 BRUNSWICK PATH
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-5162
Mailing Address - Country:US
Mailing Address - Phone:612-710-6071
Mailing Address - Fax:
Practice Address - Street 1:15251 PLEASANT VALLEY RD
Practice Address - Street 2:RW 12
Practice Address - City:CENTER CITY
Practice Address - State:MN
Practice Address - Zip Code:55012
Practice Address - Country:US
Practice Address - Phone:651-213-4797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4860101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health