Healthcare Provider Details

I. General information

NPI: 1427670488
Provider Name (Legal Business Name): WIND WAVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 PARKLAWN AVE STE 110
EDINA MN
55435-5125
US

IV. Provider business mailing address

7600 PARKLAWN AVE STE 110
EDINA MN
55435-5125
US

V. Phone/Fax

Practice location:
  • Phone: 612-486-2988
  • Fax: 612-484-4496
Mailing address:
  • Phone: 612-486-2988
  • Fax: 612-484-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: TESSA ELIZABETH WOLDEN
Title or Position: CEO
Credential: ATR, LPCC
Phone: 612-486-2988