| Supportive Change Counseling & Consulting | |
|
2335 Woodbridge St Apt 338 Roseville MN 55113-4763 | |
| (612) 367-7287 | |
| Not Available |
| Full Name | Supportive Change Counseling & Consulting |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2335 Woodbridge St Apt 338, Roseville, Minnesota |
| Authorized Official Name and Position | Antoine Jackson (OWNER / CLINICAL DIRECTOR) |
| Authorized Official Contact | 6123677287 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Change Counseling & Consulting 202 N Cedar Ave Ste 1 Owatonna MN 55060-2306 Ph: (612) 367-7287 | Supportive Change Counseling & Consulting 2335 Woodbridge St Apt 338 Roseville MN 55113-4763 Ph: (612) 367-7287 |
| NPI Number | 1235016106 |
|---|---|
| Provider Enumeration Date | 08/20/2025 |
| Last Update Date | 08/20/2025 |
| Certification Date | 08/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235016106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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