Healthcare Provider Details

I. General information

NPI: 1225974561
Provider Name (Legal Business Name): LIVING WELL AND HEALING THERAPY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8692 KENYON CT NE UNIT A
BLAINE MN
55449-7433
US

IV. Provider business mailing address

716 COUNTY ROAD 10 NE UNIT 157
BLAINE MN
55434-2331
US

V. Phone/Fax

Practice location:
  • Phone: 612-293-8339
  • Fax:
Mailing address:
  • Phone: 612-293-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DON MICHAEL COLEMAN
Title or Position: OWNER AND OUTPATIENT THERAPIST
Credential: LICSW
Phone: 612-251-1198