Livwell Therapy & Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIVWELL THERAPY & WELLNESS

Practice address

213 74TH Way N
Brooklyn Park, MN 55444-3001

Phone

(612) 456-1036

Fax

(952) 213-4117

NPI assigned

Apr 7, 2023

Organization subpart

No

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

Authorized official

Name

Elise Smith

Title

Credentialing Specialist

Phone

(952) 213-4114

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1649965419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 W 101ST ST APT 114",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554382519",
            "telephone_number": "952-213-4114",
            "fax_number": "952-213-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 74TH WAY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554443001",
            "telephone_number": "612-456-1036",
            "fax_number": "952-213-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVWELL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "952-213-4114"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.