Imagine Nation LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

IMAGINE NATION LLC

Doing business as

Mindology Mental Wellness Center

Practice address

3333 W Division St Ste 100
Saint Cloud, MN 56301-4555

Phone

(320) 266-8082

NPI assigned

Jan 11, 2022

Organization subpart

Yes

Parent organization

IMAGINE NATION LLCAs reported in NPPES

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

Authorized official

Name

Marc Van Herr

Title

Owner

Phone

(320) 266-8082

Specialties & licenses 1

Addresses

Other names 1

• Mindology Mental Wellness Center Doing business as

Part of

Imagine Nation LLC

Locations

Practitioners 1

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

• Kimberly Sue Vanheuveln, MSW, LICSW

  • Clinical Social Worker
  • Saint Cloud, MN
  • NPI 1780324988
  NPD

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1992456073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 5TH AVE N",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771653",
            "telephone_number": "320-266-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DIVISION ST STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014555",
            "telephone_number": "320-266-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE NATION LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMAGINE NATION LLC",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "HERR",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-266-8082"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindology Mental Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martha Anne Ideker, AUD
• Deborah A Idland, CRNA
• Chibuzo Ikediego
• Kay Iken, CNP
• Samantha Illsley
• Bisharo Iman
• Fardowsa Hassan Iman, LADC
• Farhiya Iman
• Muna Iman
• Aaron Daniel Imdieke, D.D.S.

• Mental Health Counselor in Saint Cloud, MN
• Providers in Saint Cloud, 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 Jan 11, 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.