Provider Demographics
NPI:1962821520
Name:MINDFUL FAMILIES
Entity Type:Organization
Organization Name:MINDFUL FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LP
Authorized Official - Phone:612-486-2956
Mailing Address - Street 1:7400 METRO BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2361
Mailing Address - Country:US
Mailing Address - Phone:612-486-2956
Mailing Address - Fax:888-974-1262
Practice Address - Street 1:7400 METRO BLVD STE 190
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2361
Practice Address - Country:US
Practice Address - Phone:612-486-2956
Practice Address - Fax:888-974-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5049103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty