Provider Demographics
NPI:1497176234
Name:REKINDLE COUNSELING, LLC
Entity Type:Organization
Organization Name:REKINDLE COUNSELING, LLC
Other - Org Name:REKINDLE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:STOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MDIV
Authorized Official - Phone:952-929-9929
Mailing Address - Street 1:3209 W 76TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5246
Mailing Address - Country:US
Mailing Address - Phone:952-929-9929
Mailing Address - Fax:
Practice Address - Street 1:3209 W 76TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5246
Practice Address - Country:US
Practice Address - Phone:952-929-9929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty