Mindful Connection Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL CONNECTION THERAPY

Practice address

657 Main St NW Ste 208
Elk River, MN 55330-1517

Phone

(612) 412-1136

Fax

(877) 775-1160

NPI assigned

Jul 2, 2022

Organization subpart

No

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

Authorized official

Name

Sarah Sumner, MSW, LICSW

Title

Owner

Phone

(612) 412-1136

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1790418267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 208",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301517",
            "telephone_number": "612-412-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 208",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301517",
            "telephone_number": "612-412-1136",
            "fax_number": "877-775-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL CONNECTION THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "SUMNER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-412-1136",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Milam
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• Kacie Kristine Miller
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• Paula Jean Minske, LMFT
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• Alexandra Marie Miskowiec, PT, DPT

• Clinical Social Worker in Elk River, MN
• Providers in Elk River, 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 Jul 22, 2022; 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.