Healthcare Provider Details

I. General information

NPI: 1275120784
Provider Name (Legal Business Name): BE WELL CENTER FOR COUNSELING & HEALING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 GREELEY ST S STE 202
STILLWATER MN
55082-6279
US

IV. Provider business mailing address

1903 GREELEY ST S STE 202
STILLWATER MN
55082-6279
US

V. Phone/Fax

Practice location:
  • Phone: 612-888-5910
  • Fax:
Mailing address:
  • Phone: 612-888-5910
  • Fax: 651-390-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLE ANN AREND
Title or Position: LIC. MARRIAGE & FAMILY THERAPIST
Credential: MA, LMFT, RPT
Phone: 612-888-5910