Industrious Healing LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INDUSTRIOUS HEALING LLC

Practice address

10501 Wayzata Blvd Ste 204
Minnetonka, MN 55305-1519

Phone

(612) 219-7620

NPI assigned

Aug 26, 2019

Organization subpart

No

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

Authorized official

Name

Emily J Laconic, LICSW

Title

Owner, Therapist

Phone

(612) 219-7620

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575676800000",
    "number": "1114575982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 ALDRICH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554303533",
            "telephone_number": "612-219-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 WAYZATA BLVD STE 204",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051519",
            "telephone_number": "612-219-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4908 Aldrich Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554303533",
            "country_code": "US",
            "telephone_number": "612-219-6720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDUSTRIOUS HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-12-07",
        "certification_date": "2019-12-07",
        "status": "A",
        "authorized_official_last_name": "LACONIC",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "612-219-7620",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2019; 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.