Healthcare Provider Details
I. General information
NPI: 1881568798
Provider Name (Legal Business Name): COUNSELING COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1121 TOWN CENTRE DR STE 203
EAGAN MN
55123-1370
US
IV. Provider business mailing address
13943 HOLYOKE CT
APPLE VALLEY MN
55124-9466
US
V. Phone/Fax
- Phone: 612-352-8507
- Fax: 651-461-9276
- Phone: 612-352-8507
- Fax: 651-461-9276
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELSEY
REHOME-PEYMANN
Title or Position: PROFESSIONAL CLINICAL COUNSELOR
Credential: LPCC
Phone: 612-720-9746