Healthcare Provider Details

I. General information

NPI: 1487581252
Provider Name (Legal Business Name): SHIELDED MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 LANDMARK PL STE 215
MADISON WI
53713-4248
US

IV. Provider business mailing address

2019 PARIS LN
COTTAGE GROVE WI
53527-9228
US

V. Phone/Fax

Practice location:
  • Phone: 920-539-0850
  • Fax:
Mailing address:
  • Phone: 920-539-0850
  • 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: STACEY SADOFF
Title or Position: OWNER
Credential: LPC
Phone: 920-539-0850