OrganizationActive
Life Interrupted Counseling Services
NPI 1033821632 · Adolescent and Children Mental Health Clinic/Center · Burnsville, MN
Provider details
- NPI number
- 1033821632
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mary Chedda, Ceo/Sole Proprietor(651) 338-8643
Specialties & taxonomies
Ambulatory Health Care Facilities
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1500 Mcandrews Rd W Ste 215
Burnsville, MN 55337-4445
Phone: (952) 222-3002
Street-level locationGet directions
Mailing address
1500 Mcandrews Rd W Ste 215
Burnsville, MN 55337-4445
Registry dates
- Enumerated
- 2022-12-15
- Last updated
- 2024-01-18
- Certified
- 2024-01-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.