INTEGRATED LIFE COUNSELING CENTER, PLLC (NPI# 1649644634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649644634 |
| Entity Type | Organization |
| Organization Name | INTEGRATED LIFE COUNSELING CENTER, PLLC |
| Practice Address |
8931 33rd Street N Lake Elmo MN 55042-8900 |
| Practice Telephone | 6512429608 |
| Practice Fax Number | 6517568138 |
| Mailing Telephone | 6512429608 |
| Mailing Fax Number | 6517568138 |
| Enumeration Date | 2015-11-14 |
| Last Update Date | 2016-09-02 |
| Authorized Official Name | MS. TRACY LEE KAYE SWANSON (DIRECTOR OF COMMUNICATIONS) |
| Authorized Official Telephone | 6512429608 |
| Authorized Official Credential | LPCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
CC00241 | MN | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 920 | MN | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 2005 | MN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP3782 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1114091709 | 05 | |
| MN | 1154562205 | 05 | |
| MN | 1629138417 | 05 | |
| MN | 1225262496 | 05 |
| Street Address |
8931 33RD STREET N |
| City | LAKE ELMO |
| State | MN |
| Zip Code | 55042-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811440738 | Eleni Voltidi | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2016-07-27 |
| 1760781314 | Swedehill Lifecare, LLC | Home Health | 8951 Highway 5, Lake Elmo, MN 55042 | 2011-03-22 |
| 1295859676 | St Croix Valley Dental Pllc | Dentist | 10035 City Walk Dr, Ste A Lake Elmo Dental, Lake Elmo, MN 55042 | 2007-03-19 |
| 1245281823 | Kent Gregory Brockmann | Psychiatry & Neurology | 8673 Eagle Point Blvd, Lake Elmo, MN 55042 | 2006-05-16 |
| 1396722674 | Nancy L Johnson-rauen | Physical Therapist | 9242 Hudson Blvd N Ste 400, Lake Elmo, MN 55042 | 2005-12-28 |
| 1639655384 | Katlyn Arndt | Psychiatry & Neurology | 8515 Eagle Point Blvd, Lake Elmo, MN 55042 | 2018-07-16 |
| 1295227247 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2018-06-05 |
| 1396120473 | Pdg, Pa | Clinic/Center | 8650 Hudson Blvd N, Suite 105, Lake Elmo, MN 55042 | 2015-07-30 |
| 1124455324 | Leslie Markowitz | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2013-10-02 |
| 1215295001 | Jessica R Baltz | Marriage & Family Therapist | 3819 Laverne Ave N, Lake Elmo, MN 55042 | 2012-04-30 |
| Find all providers in zip 55042 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915435 | Lori Peiffer, Phd, Lp, LLC | Psychologist | 8519 Eagle Point Blvd Ste 150, Lake Elmo, MN 55042-8629 | 2014-09-17 |
| 1184697427 | John M Salter | Psychologist | 8550 Hudson Blvd, Healthpartners Regions Behavioral Health-woodbury, Lake Elmo, MN 55042-8706 | 2006-02-08 |
| 1124455324 | Leslie Markowitz | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2013-10-02 |
| 1790053460 | Jennifer Jean Solin | Psychologist | 8550 Hudson Blvd N, Lake Elmo, MN 55042 | 2011-12-08 |
| 1609865674 | Jon Colombo | Psychologist | 8669 Eagle Point Blvd, Lake Elmo, MN 55042-8628 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899291 | Charlotte Mae Gerth Haanen | Psychologist | 2805 Cliff Rd E, Burnsville, MN 55337-4095 | 2020-10-17 |
| 1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1720691884 | Oluwatosin Alabi | Psychologist | 4124 Quebec Ave N Ste 307, New Hope, MN 55427-1241 | 2020-08-28 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
| 1699392266 | Jacqueline Suresh Layton | Psychologist | 17324 Glencoe Ave, Lakeville, MN 55044-7429 | 2020-06-30 |
| 1760016109 | Cori Miller | Psychologist | 7300 Metro Blvd Ste 400, Edina, MN 55439-2307 | 2020-02-25 |
| 1831722594 | Collaboration for Psychological Wellness, LLC | Psychologist | 12000 Portland Ave Ste 120, Burnsville, MN 55337-4469 | 2020-02-20 |
| 1780214601 | Jennifer Jacqueline Felinski Kurtz | Psychologist | 16688 Kentucky Ave, Lakeville, MN 55044-4616 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on INTEGRATED LIFE COUNSELING CENTER, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.