Provider Demographics
NPI:1881570810
Name:NORTHERN PATH WELLNESS LLC
Entity type:Organization
Organization Name:NORTHERN PATH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:KAMAAL
Authorized Official - Last Name:ABDULKADIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-364-8725
Mailing Address - Street 1:7327 ZANE AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3113
Mailing Address - Country:US
Mailing Address - Phone:612-364-8725
Mailing Address - Fax:
Practice Address - Street 1:7327 ZANE AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55443-3113
Practice Address - Country:US
Practice Address - Phone:612-364-8725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty