Provider Demographics
NPI:1245801133
Name:RESTORATIVE WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:RESTORATIVE WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES-SVEBACK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-636-0484
Mailing Address - Street 1:233 N MERIDIAN ST # 215
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011-1827
Mailing Address - Country:US
Mailing Address - Phone:507-210-4714
Mailing Address - Fax:
Practice Address - Street 1:217 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011-1823
Practice Address - Country:US
Practice Address - Phone:612-636-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty