Provider Demographics
NPI:1982261566
Name:MOSAIC FAMILY THERAPY, LLC
Entity Type:Organization
Organization Name:MOSAIC FAMILY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:952-452-0643
Mailing Address - Street 1:4900 HIGHWAY 169 N STE 210
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-4019
Mailing Address - Country:US
Mailing Address - Phone:952-452-0643
Mailing Address - Fax:763-432-7920
Practice Address - Street 1:4900 HIGHWAY 169 N STE 210
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-4019
Practice Address - Country:US
Practice Address - Phone:952-452-0643
Practice Address - Fax:763-432-7920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health