Living Waters Youth

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIVING WATERS YOUTH

Practice address

5701 Shingle Creek Pkwy
Minneapolis, MN 55430-2467

Phone

(612) 703-3313

NPI assigned

Oct 2, 2025

Organization subpart

No

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

Authorized official

Name

Tanneka Harrington

Title

Ceo

Phone

(612) 703-3313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1144194002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 JAMES AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554111243",
            "telephone_number": "612-703-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 SHINGLE CREEK PKWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554302467",
            "telephone_number": "612-703-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS YOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "TANNEKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-703-3313"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, 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 Oct 2, 2025; 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.