Mindful Restoration LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MINDFUL RESTORATION LLC

Practice address

7400 Metro Blvd Ste 335
Edina, MN 55439-2356

Phone

(952) 992-9646

Fax

(612) 465-3032

NPI assigned

Jun 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cortney L Amundson, MA, LPCC, BCNNPI 1659811826

Title

Mental Health Therapist

Phone

(952) 992-9646

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cortney Lynn Amundson, M.A. LPCC, BCN

  • Professional Counselor
  • Edina, MN
  • NPI 1659811826
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1104442268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 335",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392356",
            "telephone_number": "952-992-9646",
            "fax_number": "612-465-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 335",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392356",
            "telephone_number": "952-992-9646",
            "fax_number": "612-465-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL RESTORATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "AMUNDSON",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "952-992-9646",
        "authorized_official_credential": "MA, LPCC, BCN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Edina",
            "affiliation": "N",
            "endpointDescription": "Direct terminal communication",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7400 Metro Blvd Ste 335",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554392356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.