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General NPI Number Information
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NPI Number | 1912752403
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Entity Type | Organization
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Legal Business Name | MIND AND BODY COUNSELING
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 15088 22ND AVE NE STE 2
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City | LITTLE FALLS
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State | MN
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Zip | 56345-3634
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Country | US
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Telephone | 320-630-2782
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Fax | 888-892-4587
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Provider Business Mailing Address
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Address Line | 6568 230TH ST
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City | RANDALL
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State | MN
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Zip | 56475-2414
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Country | US
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Telephone | 320-630-2782
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Fax | 888-892-4587
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE LOCKEN
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Credential |
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Telephone | 320-630-2782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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