Healthcare Provider Details

I. General information

NPI: 1376462796
Provider Name (Legal Business Name): HEALING WITH WILDFLOWERS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36463 ELK AVE
NORTH BRANCH MN
55056-5579
US

IV. Provider business mailing address

36463 ELK AVE
NORTH BRANCH MN
55056-5579
US

V. Phone/Fax

Practice location:
  • Phone: 651-592-8556
  • Fax:
Mailing address:
  • Phone: 651-592-8556
  • 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: JAMIE NELSON
Title or Position: OWNER
Credential: LADC, LPCC
Phone: 651-592-8556