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General NPI Number Information
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NPI Number | 1679167126
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Entity Type | Organization
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Legal Business Name | MOSAIC THERAPY GROUP
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 7777 WASHINGTON AVE S
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City | EDINA
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State | MN
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Zip | 55439-2422
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Country | US
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Telephone | 651-398-6877
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Fax | 612-315-6001
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Provider Business Mailing Address
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Address Line | 7777 WASHINGTON AVE S STE 101
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City | EDINA
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State | MN
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Zip | 55439-2469
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Country | US
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Telephone | 651-398-6877
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | DR. NAOMI SCHWENKE
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Credential | PHD, LMFT
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Telephone | 612-464-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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