Provider Demographics
NPI:1982848883
Name:PARTNERS IN HEALING OF MINNEAPOLIS
Entity Type:Organization
Organization Name:PARTNERS IN HEALING OF MINNEAPOLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CEDARLEAF
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:763-546-5797
Mailing Address - Street 1:10201 WAYZATA BLVD
Mailing Address - Street 2:SUITE #350
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5507
Mailing Address - Country:US
Mailing Address - Phone:763-546-5797
Mailing Address - Fax:763-546-5754
Practice Address - Street 1:10201 WAYZATA BLVD
Practice Address - Street 2:SUITE #350
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5507
Practice Address - Country:US
Practice Address - Phone:763-546-5797
Practice Address - Fax:763-546-5754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17268101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty