Provider Demographics
NPI:1366944597
Name:CONSCIOUS HEALING COUNSELING INC
Entity type:Organization
Organization Name:CONSCIOUS HEALING COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:815-973-0999
Mailing Address - Street 1:20495 GADWALL LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-8767
Mailing Address - Country:US
Mailing Address - Phone:815-973-0999
Mailing Address - Fax:
Practice Address - Street 1:2705 BUNKER LAKE BLVD NW STE 112
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-3785
Practice Address - Country:US
Practice Address - Phone:815-973-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-04
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty