Healthcare Provider Details

I. General information

NPI: 1932912300
Provider Name (Legal Business Name): ADVENTURES WITHIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E RIVER RD STE 205
BRAINERD MN
56401-3515
US

IV. Provider business mailing address

16248 BIRCHWOOD LN
BRAINERD MN
56401-6183
US

V. Phone/Fax

Practice location:
  • Phone: 218-270-9525
  • Fax: 218-524-3445
Mailing address:
  • Phone: 218-251-3647
  • Fax: 218-524-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMIE T WHITEMAN
Title or Position: OWNER
Credential: LICSW
Phone: 218-251-3647