Provider Demographics
NPI:1366862070
Name:BHAKTI MENTAL HEALTH
Entity Type:Organization
Organization Name:BHAKTI MENTAL HEALTH
Other - Org Name:BHAKTI HOLISTIC MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUSKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-524-9237
Mailing Address - Street 1:7550 FRANCE AVE S
Mailing Address - Street 2:STE 220
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5624
Mailing Address - Country:US
Mailing Address - Phone:612-859-7709
Mailing Address - Fax:
Practice Address - Street 1:7550 FRANCE AVE S
Practice Address - Street 2:STE 220
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5624
Practice Address - Country:US
Practice Address - Phone:612-859-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty