Healthcare Provider Details

I. General information

NPI: 1053937029
Provider Name (Legal Business Name): ENCOMPASS HOPE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 12/19/2021
Certification Date: 12/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 WASHINGTON DR STE 214
EAGAN MN
55122-4304
US

IV. Provider business mailing address

3460 WASHINGTON DR STE 214
EAGAN MN
55122-4304
US

V. Phone/Fax

Practice location:
  • Phone: 651-412-5088
  • Fax:
Mailing address:
  • Phone: 651-412-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHANNON WOHLMAN
Title or Position: CO-OWNER
Credential: LMFT, LSW
Phone: 651-412-5088