Provider Demographics
NPI:1457677601
Name:PEACES 'N PUZSOULS: JOURNIES THRU HEALING
Entity Type:Organization
Organization Name:PEACES 'N PUZSOULS: JOURNIES THRU HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:651-797-4094
Mailing Address - Street 1:1821 UNIVERSITY AVE W
Mailing Address - Street 2:STE S326
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2801
Mailing Address - Country:US
Mailing Address - Phone:651-797-4094
Mailing Address - Fax:651-797-4094
Practice Address - Street 1:1821 UNIVERSITY AVE W
Practice Address - Street 2:STE S326
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2801
Practice Address - Country:US
Practice Address - Phone:651-797-4094
Practice Address - Fax:651-797-4094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14893261Q00000X
261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN170094483OtherINDIVIDUAL NPI