# MOSAIC FAMILY SERVICES, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275195737
- **Authorized official:** JEREMY ROBISON FAUS LMFT (DIRECTOR)
- **Authorized official phone:** (952) 217-6419

## Contact information

- **Practice address:** 1405 EAST MAIN STREET, NEW PRAGUE, MN 56071
- **Practice address phone:** (952) 217-6419
- **Practice address fax:** (952) 758-9022
- **Mailing address:** 1405 EAST MAIN STREET, NEW PRAGUE, MN 56071
- **Mailing address phone:** (952) 217-6419
- **Mailing address fax:** (952) 758-9022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2019
- **Last updated:** 07/05/2019