NPIMap

Organization Active NPI

Mindful Way Counseling, LLC

  • Clinical Social Worker
  • Fridley, MN
National Provider Identifier
1336615202
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDFUL WAY COUNSELING, LLC
Practice address
1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135
Phone
(612) 389-2332
Fax
(612) 389-2338
NPI assigned
Oct 18, 2018
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Andrea Patten, LICSWNPI 1396025383
Title
Director
Phone
(612) 389-2332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Professional Counselor 101YP2500X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135

Mailing address

1250 Moore Lake Dr E Ste 152
Fridley, MN 55432-5135
Phone (612) 389-2332

National Provider Directory

National Provider Directory

Locations

1250 Moore Lake Dr E
Ste 152
Fridley, MN 55432
Phone (612) 389-2332

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1336615202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 152",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325135",
            "telephone_number": "612-389-2332",
            "fax_number": "612-389-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 152",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325135",
            "telephone_number": "612-389-2332",
            "fax_number": "612-389-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL WAY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "PATTEN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-389-2332",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.