Healthcare Provider Details

I. General information

NPI: 1245075209
Provider Name (Legal Business Name): REDEFINE MENTAL HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S FRONTAGE RD STE 6
HASTINGS MN
55033-2489
US

IV. Provider business mailing address

1303 S FRONTAGE RD STE 271
HASTINGS MN
55033-2691
US

V. Phone/Fax

Practice location:
  • Phone: 651-401-2533
  • Fax: 651-252-1856
Mailing address:
  • Phone: 612-503-2159
  • Fax: 651-262-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. KARENA ROTHER
Title or Position: PRESIDENT
Credential: MSN, APRN, PMHNP-BC
Phone: 612-503-2159