Healthcare Provider Details

I. General information

NPI: 1306260005
Provider Name (Legal Business Name): PATHWAYS TO WELLNESS MINNESOTA LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2014
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 WILLOW ST STE 109
MINNEAPOLIS MN
55403-2241
US

IV. Provider business mailing address

1409 WILLOW ST STE 109
MINNEAPOLIS MN
55403-2241
US

V. Phone/Fax

Practice location:
  • Phone: 612-474-1700
  • Fax: 612-474-1710
Mailing address:
  • Phone: 612-474-1700
  • Fax: 612-474-1710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1681
License Number StateCO

VIII. Authorized Official

Name: MS. JENNIFER ANN BAUMGARDNER BARNES
Title or Position: PRESIDENT AND PROVIDER
Credential: MSW, LICSW, LCSW
Phone: 612-474-1700