| Mindful Wellbeing | |
|
199 Coon Rapids Blvd Nw Ste 208 Coon Rapids MN 55433-5860 | |
| (612) 440-1899 | |
| Not Available |
| Full Name | Mindful Wellbeing |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/18/2019 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Medicare PECOS PAC ID | 2860855897 |
|---|---|
| Medicare Enrollment ID | O20230824000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861038515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Branden David Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215393483 PECOS PAC ID: 9931527652 Enrollment ID: I20200912000087 |
| Provider Name | Kristin L Jorgensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912576109 PECOS PAC ID: 8527457811 Enrollment ID: I20211108000201 |
| Provider Name | Kjerstin Rydeen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689303661 PECOS PAC ID: 1456704923 Enrollment ID: I20240131003486 |
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