Healthcare Provider Details

I. General information

NPI: 1912782749
Provider Name (Legal Business Name): INMIND HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 HAZELTINE BLVD SUITE 496, MD 45
CHASKA MN
55318-1000
US

IV. Provider business mailing address

11761 RIVERVIEW RD
EDEN PRAIRIE MN
55347-4912
US

V. Phone/Fax

Practice location:
  • Phone: 952-240-3344
  • Fax: 952-941-6414
Mailing address:
  • Phone: 952-295-8831
  • Fax: 952-295-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STACEY ALLEN
Title or Position: OWNER, THERAPIST
Credential: LMFT
Phone: 952-295-8815