Provider Demographics
NPI:1508107541
Name:INVIGORATE LIFE COUNSELING, PLLC
Entity Type:Organization
Organization Name:INVIGORATE LIFE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:MP
Authorized Official - Last Name:VINTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:651-983-3879
Mailing Address - Street 1:1154 GRAND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104
Mailing Address - Country:US
Mailing Address - Phone:651-983-3879
Mailing Address - Fax:
Practice Address - Street 1:1154 GRAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2628
Practice Address - Country:US
Practice Address - Phone:651-983-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)