Provider Demographics
NPI:1669363313
Name:MINDBODY NAVIGATION THERAPY PLLC
Entity type:Organization
Organization Name:MINDBODY NAVIGATION THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOREA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:701-720-7702
Mailing Address - Street 1:8641 22ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:LANSFORD
Mailing Address - State:ND
Mailing Address - Zip Code:58750-2200
Mailing Address - Country:US
Mailing Address - Phone:701-720-7702
Mailing Address - Fax:
Practice Address - Street 1:8641 22ND AVE NW
Practice Address - Street 2:
Practice Address - City:LANSFORD
Practice Address - State:ND
Practice Address - Zip Code:58750-2200
Practice Address - Country:US
Practice Address - Phone:701-720-7702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty