Provider Demographics
NPI:1962553974
Name:LOMPART, JOAN S (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:LOMPART
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 1:1500 MCANDREWS RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337
Mailing Address - Country:US
Mailing Address - Phone:952-892-8404
Mailing Address - Fax:952-892-1722
Practice Address - Street 1:1500 MCANDREWS RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337
Practice Address - Country:US
Practice Address - Phone:952-892-8404
Practice Address - Fax:952-892-1722
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN99G53LOOtherBLUE CROSS BLUE SHIELD MN