Mindfully Healing Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MINDFULLY HEALING INC.

Practice address

4154 Shoreline Dr Ste 202
Spring Park, MN 55384-5606

Phone

(952) 491-9450

Fax

(952) 491-9460

NPI assigned

Jul 11, 2020

Last updated

Jul 31, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mitchell Lee Olson, LPCCNPI 1831677103

Title

Owner

Phone

(612) 562-9880

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mitchell Lee Olson, LPCC

  • Mental Health Counselor
  • Spring Park, MN
  • NPI 1831677103
  NPD Authorized official
• Kelly Jean Tibbetts, LICSW

  • Clinical Social Worker
  • Spring Park, MN
  • NPI 1992350367
  NPD
• Ashley Nicole Wurdeman, LMFT

  • Marriage & Family Therapist
  • Spring Park, MN
  • NPI 1750063301
  NPD

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

{
    "created_epoch": "1594425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1235757600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4154 SHORELINE DR STE 202",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553845606",
            "telephone_number": "952-491-9450",
            "fax_number": "952-491-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 SHORELINE DR STE 202",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553845606",
            "telephone_number": "952-491-9450",
            "fax_number": "952-491-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLY HEALING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-11",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-562-9880",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthy Miles LLC
• Jill Renee Heuer
• Kyle R Danielson, DDS, PLLC (Spring Park Dentistry)
• James D Lehmann, MD
• Judith L Miller, MD
• Josephine Mkapa
• Eric A Nagle, MD
• Steven Jay Nerheim, M.D.
• Novus Healthcare Group, LLC
• Archy Olson

• Mental Health Counselor in Spring Park, MN
• Providers in Spring Park, 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 Jul 31, 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.