MK Assisted Living Ijnc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MK ASSISTED LIVING IJNC

Practice address

10525 Lyndale Ave S
Bloomington, MN 55420-5240

Phone

(952) 245-3016

NPI assigned

Oct 23, 2025

Organization subpart

No

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

Authorized official

Name

Samatar Farah

Title

Director

Phone

(952) 245-3016

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1316814254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554205240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554205240",
            "telephone_number": "952-245-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK ASSISTED LIVING IJNC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "SAMATAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-245-3016"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Renae Mitchell
• Scott Archer Mitchell
• Tara Mitchell
• Travon Amor C Mitchell
• Steven Mizak
• Kawsar Mohamed Moalim
• Elizabeth Joy Moe, DPT
• Isabella Faith Moechnig
• Carolynne J Moffat, LMFT
• Sharon K Mogaka

• Mental Health Counselor in Bloomington, MN
• Providers in Bloomington, 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 23, 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.