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NPI 1821761065

NPI 1821761065 : OAK HAVEN COUNSELING AND WELLNESS LLC : LINDSTROM, MN

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General NPI Number Information
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    NPI Number           |    1821761065
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    Entity Type          |    Organization 
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    Legal Business Name  |    OAK HAVEN COUNSELING AND WELLNESS LLC 
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Dates
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    Enumeration Date     |    07/25/2021
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    Last Update Date     |    01/20/2026
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Provider Practice Location Address
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    Address Line         |    35890 OASIS RD 
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    City                 |    LINDSTROM
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    State                |    MN
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    Zip                  |    55045-7343
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    Country              |    US
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    Telephone            |    952-228-3487
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 421 
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    City                 |    ISANTI
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    State                |    MN
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    Zip                  |    55040-0421
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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    |    OWNER
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    Name                 |     HEATHER  CRONEMILLER 
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    Credential           |    LICSW
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    Telephone            |    218-368-1187
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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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