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General NPI Number Information
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NPI Number | 1629915608
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Entity Type | Organization
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Legal Business Name | LITTLE MINDS WELLNESS LLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 102 E GREEN BAY ST STE 101
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City | SHAWANO
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State | WI
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Zip | 54166-2444
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Country | US
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Telephone | 715-280-8130
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Fax | 715-280-8138
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Provider Business Mailing Address
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Address Line | PO BOX 115
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City | WITTENBERG
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State | WI
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Zip | 54499-0115
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Country | US
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Telephone | 715-701-0476
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. AMANDA BADDMOCCOSIN-BARNES
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Credential | LCSW
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Telephone | 715-701-0476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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