Afiya Spiritual Life Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7784 Issued in MN

Legal business name

AFIYA SPIRITUAL LIFE CENTER, LLC

Practice address

6009 Wayzata Blvd
Suite 114
St Louis Park, MN 55416-1223

Phone

(651) 260-5419

NPI assigned

Nov 7, 2013

Last updated

Nov 7, 2013By 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

Dara Ceaser, MSW, LICSWNPI 1851720023

Title

Social Worker

Phone

(651) 260-5419

Specialties & licenses 1

Addresses

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.

• Dara Ceaser, MSW, LICSW

  • Mental Health Counselor
  • St Louis Park, MN
  • NPI 1851720023
  NPD (past) Authorized official

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1962831107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 WAYZATA BLVD",
            "address_2": "SUITE 114",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161223",
            "telephone_number": "651-260-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6009 WAYZATA BLVD",
            "address_2": "SUITE 114",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161223",
            "telephone_number": "651-260-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFIYA SPIRITUAL LIFE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "CEASER",
        "authorized_official_first_name": "DARA",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "651-260-5419",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "7784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.