Provider Demographics
NPI:1285443424
Name:THRIVING MINDS LLC
Entity type:Organization
Organization Name:THRIVING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:CHELLANGAT
Authorized Official - Last Name:CHEMARUM
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:612-600-2856
Mailing Address - Street 1:6853 99TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-1071
Mailing Address - Country:US
Mailing Address - Phone:612-600-2856
Mailing Address - Fax:
Practice Address - Street 1:2042 WOODDALE DR STE 250
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4421
Practice Address - Country:US
Practice Address - Phone:651-401-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty