Organization
AURORA HEALING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN SHAYLOR ALLEY MA, LADC, LPCC (CEO)
(763) 412-1994
Entity
Organization
Contact information
Practice address
657 MAIN ST NW STE 214, ELK RIVER, MN 55330-1579
(763) 412-1994
Mailing address
657 MAIN ST NW STE 214, ELK RIVER, MN 55330-1579
(763) 412-1994
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649781311
—
MN
05
—
1861567513
—
MN
Enumeration date
01/30/2019
Last updated
02/11/2020
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