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General NPI Number Information
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NPI Number | 1619562113
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Entity Type | Organization
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Legal Business Name | CATALYST INSIGHT COLLECTIVE, LLC
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 2855 ANTHONY LN S STE 140
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City | ST ANTHONY
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State | MN
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Zip | 55418-2880
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Country | US
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Telephone | 612-444-1655
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 ANTHONY LN S STE 140
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City | MINNEAPOLIS
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State | MN
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Zip | 55418-2880
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED THERAPIST
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Name | MRS. SHIREEN GHANATABADI
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Credential | MA, LPCC, SEP
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Telephone | 612-444-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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