Sexual Wellness Institute

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2382 Issued in MN

Legal business name

SEXUAL WELLNESS INSTITUTE

Practice address

2291 Waters Dr
Mendota Heights, MN 55120-1363

Phone

(651) 401-5010

Fax

(612) 235-6447

NPI assigned

Apr 14, 2015

Organization subpart

No

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

Authorized official

Name

Amanda Holmberg, LMFT

Title

Owner

Phone

(763) 607-8035

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1508252719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 WATERS DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201363",
            "telephone_number": "651-401-5010",
            "fax_number": "612-235-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 WATERS DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201363",
            "telephone_number": "651-401-5010",
            "fax_number": "612-235-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEXUAL WELLNESS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-607-8035",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.