Mindful Wellbeing | |
199 Coon Rapids Blvd Nw Ste 208 Coon Rapids MN 55433-5860 | |
(612) 440-1899 | |
Not Available |
Full Name | Mindful Wellbeing |
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Speciality | Social Worker |
Location | 199 Coon Rapids Blvd Nw Ste 208, Coon Rapids, Minnesota |
Authorized Official Name and Position | Amanda Wannarka (OWNER, PSYCHOTHERAPIST) |
Authorized Official Contact | 6123092691 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mindful Wellbeing 199 Coon Rapids Blvd Nw Ste 208 Coon Rapids MN 55433-5860 Ph: (612) 440-1899 | Mindful Wellbeing 199 Coon Rapids Blvd Nw Ste 208 Coon Rapids MN 55433-5860 Ph: (612) 440-1899 |
NPI Number | 1861038515 |
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Provider Enumeration Date | 11/18/2019 |
Last Update Date | 06/14/2023 |
Certification Date | 06/14/2023 |
Medicare PECOS PAC ID | 2860855897 |
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Medicare Enrollment ID | O20230824000341 |
Identifier | Type | State | Issuer |
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1861038515 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Branden David Phillips |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215393483 PECOS PAC ID: 9931527652 Enrollment ID: I20200912000087 |
Provider Name | Kristin L Jorgensen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1912576109 PECOS PAC ID: 8527457811 Enrollment ID: I20211108000201 |
Provider Name | Kjerstin Rydeen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1689303661 PECOS PAC ID: 1456704923 Enrollment ID: I20240131003486 |
Provider Name | Lisa Nemitz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215679477 PECOS PAC ID: 4284071432 Enrollment ID: I20240322002938 |
Provider Name | Paul Reps |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1073967352 PECOS PAC ID: 4688016413 Enrollment ID: I20240524002364 |
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