Healthcare Provider Details

I. General information

NPI: 1194577643
Provider Name (Legal Business Name): MINDFUL BEGINNINGS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5471 JEAN DULUTH RD
DULUTH MN
55803-9749
US

IV. Provider business mailing address

5471 JEAN DULUTH RD
DULUTH MN
55803-9749
US

V. Phone/Fax

Practice location:
  • Phone: 218-260-6332
  • Fax: 218-219-9739
Mailing address:
  • Phone: 218-260-6332
  • Fax: 218-219-9739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHELY D SKADSEM
Title or Position: OWNER/CLINICIAN
Credential: LPCC
Phone: 218-260-6332