Healthcare Provider Details

I. General information

NPI: 1114819935
Provider Name (Legal Business Name): HEALING WATERS COUNSELING & PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 4TH ST STE 3
GRAND RAPIDS MN
55744-2730
US

IV. Provider business mailing address

201 NW 4TH ST STE 3
GRAND RAPIDS MN
55744-2730
US

V. Phone/Fax

Practice location:
  • Phone: 218-259-7797
  • Fax:
Mailing address:
  • Phone: 218-259-7797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRANDON PAUL STENZEL
Title or Position: OWNER/ PROVIDER
Credential:
Phone: 651-564-1075