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Organization

SOUL CENTERED THERAPY, LLC

Active
Other names
Experience Healing, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NICOLE LYNN CASEY LMFT (FOUNDER)
(612) 242-6338
Entity
Organization

Contact information

Practice address
4959 OLSON MEMORIAL HWY STE B, GOLDEN VALLEY, MN 55422-5159
(612) 242-6338
Mailing address
4959 OLSON MEMORIAL HWY STE B, GOLDEN VALLEY, MN 55422-5159
(612) 242-6338

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2084P0800X
Psychiatry Physician
253Z00000X
In Home Supportive Care Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
02/12/2024
Last updated
10/27/2025
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