| Soulfully Rewritten Therapy | |
|
6600 City West Pkwy Ste 125 Eden Prairie MN 55344-3261 | |
| (952) 314-4449 | |
| Not Available |
| Full Name | Soulfully Rewritten Therapy |
|---|---|
| Speciality | Counselor |
| Location | 6600 City West Pkwy Ste 125, Eden Prairie, Minnesota |
| Authorized Official Name and Position | Brittni A Ingvaldson (OWNER/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 9523144449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulfully Rewritten Therapy 6600 City West Pkwy Ste 125 Eden Prairie MN 55344-3261 Ph: (952) 314-4449 | Soulfully Rewritten Therapy 6600 City West Pkwy Ste 125 Eden Prairie MN 55344-3261 Ph: (952) 314-4449 |
| NPI Number | 1699570713 |
|---|---|
| Provider Enumeration Date | 02/13/2025 |
| Last Update Date | 04/30/2025 |
| Certification Date | 04/30/2025 |
| Medicare PECOS PAC ID | 1557888484 |
|---|---|
| Medicare Enrollment ID | O20250505002434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699570713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brittni Amanda Ingvaldson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922772383 PECOS PAC ID: 1951839208 Enrollment ID: I20250114002365 |
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