Mindfully Blessed LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MINDFULLY BLESSED LLC

Practice address

202 Mesabi Location N
Biwabik, MN 55708

Phone

(218) 212-5700

NPI assigned

May 25, 2022

Last updated

May 31, 2022By 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

Kristine Lee Edstrom, LPCCNPI 1225679053

Title

Owner

Phone

(218) 591-6023

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• Kristine Lee Edstrom, LPCC

  • Professional Counselor
  • Virginia, MN
  • NPI 1225679053
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1609514918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "BIWABIK",
            "state": "MN",
            "postal_code": "557080498",
            "telephone_number": "218-591-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MESABI LOCATION N",
            "city": "BIWABIK",
            "state": "MN",
            "postal_code": "55708",
            "telephone_number": "218-212-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFULLY BLESSED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "EDSTROM",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-591-6023",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kris@mindfullyblessed.onmicrosoft.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "202 Mesabi Location N",
            "city": "Biwabik",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Biwabik Family Dental, PA
• City of Biwabik (Biwabik Fire Department Ambulance)
• Jerald Mitchell
• Paul John Stark, DDS

• Community/Behavioral Health Agency in Biwabik, MN
• Providers in Biwabik, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.