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WEST LAKE COUNSELING AND WELLNESS, INC
NPI 1255791745
Social Worker - Clinical in Long Lake, MN

Active since February 26, 2016
1613 W WAYZATA BLVD STE B, LONG LAKE, MN 55356(612) 386-2311 Get Directions Write a Review

NPPES record last updated: February 26, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About West Lake Counseling And Wellness, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WEST LAKE COUNSELING AND WELLNESS, INC (NPI 1255791745) is a healthcare organization registered as a clinical in Long Lake, Minnesota and active in the NPI registry since February 2016. The organization lists Tara Bauman Mizuhata, President, as its authorized official.

NPPES Registry Identity

NPI1255791745
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameWEST LAKE COUNSELING AND WELLNESS, INC
Location Address1613 W WAYZATA BLVD STE BLong Lake, MN 55356-4103
Mailing Address470 County Road 110 NMound, MN 55364-8315 · (612) 386-2311
Phone(612) 386-2311
Organization SubpartNo
Authorized OfficialTara Bauman MizuhataPresident · (612) 386-2311
Enumeration DateFebruary 26, 2016
✔ NPI 1255791745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MN · 18016✔ Licensed in MN · 18044
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1613 W WAYZATA BLVD STE B, Long Lake, MN 55356
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is West Lake Counseling And Wellness, Inc's NPI number?

The NPI number for West Lake Counseling And Wellness, Inc is 1255791745. It was assigned to this organization in the NPPES registry on February 26, 2016.

Where is West Lake Counseling And Wellness, Inc located?

West Lake Counseling And Wellness, Inc is located at 1613 W Wayzata Blvd Ste B, Long Lake, MN 55356. The listed phone number is (612) 386-2311.

What is West Lake Counseling And Wellness, Inc's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for West Lake Counseling And Wellness, Inc was last updated on February 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.