Provider Demographics
NPI:1598436198
Name:EXPANDING CIRCLES, INC
Entity Type:Organization
Organization Name:EXPANDING CIRCLES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMFT
Authorized Official - Phone:612-254-5963
Mailing Address - Street 1:3790 VAN DYKE ST
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-4740
Mailing Address - Country:US
Mailing Address - Phone:612-254-5963
Mailing Address - Fax:
Practice Address - Street 1:1000 COUNTY ROAD E W STE 142
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8027
Practice Address - Country:US
Practice Address - Phone:612-254-5963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty