Healing Path and Counseling Center, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5667 Issued in MN

Legal business name

HEALING PATH AND COUNSELING CENTER, LLC

Practice address

1821 University Ave W Ste 105
Saint Paul, MN 55104-2804

Phone

(612) 568-1475

NPI assigned

Jan 26, 2018

Last updated

Jan 26, 2018By 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

Anisa Sophia Mohammed, PSYD, LP

Title

Psychologist

Phone

(813) 401-7624

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516924800000",
    "number": "1740788538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 STEVENS AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083214",
            "telephone_number": "813-401-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 105",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042804",
            "telephone_number": "612-568-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING PATH AND COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "ANISA",
        "authorized_official_middle_name": "SOPHIA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "813-401-7624",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "5667",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Saint Paul, MN
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• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.