# CENTERLIFE COUNSELING, LLC

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

## Provider details

- **NPI number:** 1417283946
- **Authorized official:** KIMBERLY ANN LUNDHOLM-EADES (OWNER)
- **Authorized official phone:** (651) 288-0332

## Contact information

- **Practice address:** 7039 20TH AVE, CENTERVILLE, MN 55038-9737
- **Practice address phone:** (651) 288-0332
- **Mailing address:** 7039 20TH AVE, CENTERVILLE, MN 55038-9737
- **Mailing address phone:** (651) 288-0332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TF0000X | Family Psychologist | — | NULL | — |
| 103TF0000X | Family Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | 942 | MN | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 10/18/2009
- **Last updated:** 01/21/2019