| Enlightened Path Behavioral Health & Wellness, Llc., | |
|
5380 Bounty St Se Prior Lake MN 55372-2501 | |
| (763) 327-7061 | |
| (612) 488-0596 |
| Full Name | Enlightened Path Behavioral Health & Wellness, Llc., |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5380 Bounty St Se, Prior Lake, Minnesota |
| Authorized Official Name and Position | Stephanie Kandie (OWNER, THERAPIST) |
| Authorized Official Contact | 7633277061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enlightened Path Behavioral Health & Wellness, Llc., 5380 Bounty St Se Prior Lake MN 55372-2501 Ph: (612) 860-7221 | Enlightened Path Behavioral Health & Wellness, Llc., 5380 Bounty St Se Prior Lake MN 55372-2501 Ph: (763) 327-7061 |
| NPI Number | 1831813765 |
|---|---|
| Provider Enumeration Date | 10/04/2022 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831813765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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