Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Samuel Joseph Egertson

Individual provider Counselor · NPI 1053885756

Mr. Samuel Joseph Egertson is a Counselor in St Louis Park, Minnesota. Licensed in Minnesota and Missouri. Registered with an NPI since 2019.

Licensed in
MN, MO
In the registry since
2019
Specialties on file
2

Practice location Address checks out

5407 Excelsior Blvd Ste B
St Louis Park, MN 55416-2932
Phone: (612) 787-2832
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X (MN)
Counselor Taxonomy 101Y00000X · Licence 2018038889 (MO)

Record details

NPI number1053885756
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 15, 2019
Last updated in NPPESJune 15, 2021
Certification dateMay 29, 2021

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