Organization
AWAKEN RECOVERY COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIE COLEMAN LICSW (CEO/THERAPIST)
(763) 331-2161
Entity
Organization
Contact information
Practice address
1650 W END BLVD STE 100, ST LOUIS PARK, MN 55416-5369
(763) 331-2161
(763) 331-2161
Mailing address
1650 W END BLVD STE 100, ST LOUIS PARK, MN 55416-5369
(763) 331-2161
(763) 331-2161
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/01/2025
Last updated
03/01/2026
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