Provider Demographics
NPI:1578364881
Name:HASBARGEN, JILL CARRIE (LMFT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:CARRIE
Last Name:HASBARGEN
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 TOWN ROAD 124
Mailing Address - Street 2:
Mailing Address - City:BIRCHDALE
Mailing Address - State:MN
Mailing Address - Zip Code:56623-2733
Mailing Address - Country:US
Mailing Address - Phone:218-434-0980
Mailing Address - Fax:
Practice Address - Street 1:519 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4276
Practice Address - Country:US
Practice Address - Phone:218-444-2845
Practice Address - Fax:218-444-2847
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4470106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist