Provider Demographics
NPI:1124874458
Name:NURTURING MINDS PLAY THERAPY
Entity type:Organization
Organization Name:NURTURING MINDS PLAY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-419-1159
Mailing Address - Street 1:1061 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1061 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3002
Practice Address - Country:US
Practice Address - Phone:612-208-7446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health