Healthcare Provider Details

I. General information

NPI: 1376456962
Provider Name (Legal Business Name): INCONTROL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 WABASHA ST N STE 800
SAINT PAUL MN
55102-1331
US

IV. Provider business mailing address

8362 TAMARACK VLG STE 119
WOODBURY MN
55125-3392
US

V. Phone/Fax

Practice location:
  • Phone: 651-283-2285
  • Fax:
Mailing address:
  • Phone: 651-283-2285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KELSEY FRANCES TIMS JOSON
Title or Position: CEO
Credential:
Phone: 651-283-2285