NPIMap

Organization Active NPI

Enlightened Path Behavioral Health & Wellness, LLC.,

  • Mental Health Counselor
  • Prior Lake, MN
National Provider Identifier
1831813765
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ENLIGHTENED PATH BEHAVIORAL HEALTH & WELLNESS, LLC.,
Practice address
5380 Bounty St SE
Prior Lake, MN 55372-2501
Phone
(763) 327-7061
Fax
(612) 488-0596
NPI assigned
Oct 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Stephanie Kandie, MA, LADC, LPCCNPI 1639779135
Title
Owner, Therapist
Phone
(763) 327-7061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5380 Bounty St SE
Prior Lake, MN 55372-2501

Mailing address

5380 Bounty St SE
Prior Lake, MN 55372-2501
Phone (612) 860-7221

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Stephanie@enlightenedpath.org

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: stephanie@enlightenedpath.org

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1831813765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 BOUNTY ST SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722501",
            "telephone_number": "612-860-7221",
            "fax_number": "612-488-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 BOUNTY ST SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722501",
            "telephone_number": "763-327-7061",
            "fax_number": "612-488-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIGHTENED PATH BEHAVIORAL HEALTH & WELLNESS, LLC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "KANDIE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "763-327-7061",
        "authorized_official_credential": "MA, LADC, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Stephanie@enlightenedpath.org",
            "affiliation": "N",
            "address_1": "5380 Bounty St SE",
            "city": "Prior Lake",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553722501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.