Provider Demographics
NPI:1689040222
Name:NURTURE COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:NURTURE COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-564-8476
Mailing Address - Street 1:4444 W 76TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5173
Mailing Address - Country:US
Mailing Address - Phone:612-564-8476
Mailing Address - Fax:
Practice Address - Street 1:4444 W 76TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5173
Practice Address - Country:US
Practice Address - Phone:612-564-8476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POST PARTUM SUPPORT MINNESOTA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN176011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH300158864Medicare PIN