Provider Demographics
NPI:1720795065
Name:SUCCEEDING WITH ADD LLC
Entity Type:Organization
Organization Name:SUCCEEDING WITH ADD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-965-3052
Mailing Address - Street 1:11800 SINGLETREE LN STE 204
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5397
Mailing Address - Country:US
Mailing Address - Phone:612-965-3052
Mailing Address - Fax:612-460-0908
Practice Address - Street 1:11800 SINGLETREE LN STE 204
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-5397
Practice Address - Country:US
Practice Address - Phone:612-965-3052
Practice Address - Fax:612-460-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty