Healthcare Provider Details

I. General information

NPI: 1316616014
Provider Name (Legal Business Name): CHANGING PATHWAYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 TROOP DR
SARTELL MN
56377-4563
US

IV. Provider business mailing address

2151 TROOP DR
SARTELL MN
56377-4563
US

V. Phone/Fax

Practice location:
  • Phone: 320-425-0300
  • Fax: 320-425-0400
Mailing address:
  • Phone: 320-425-0300
  • Fax: 320-425-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BISCHOFF
Title or Position: OWNER
Credential: LMFT
Phone: 320-425-0300