INSTITUTE FOR THERAPY & BEHAVIOR CHANGE, LTD. (NPI# 1548488331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548488331 |
| Entity Type | Organization |
| Organization Name | INSTITUTE FOR THERAPY & BEHAVIOR CHANGE, LTD. |
| Practice Address |
3919 W 44th St Ste 200 Edina MN 55424-1032 |
| Practice Telephone | 9529221977 |
| Practice Fax Number | 9529221980 |
| Mailing Telephone | 9529221977 |
| Mailing Fax Number | 9529221980 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. KATHLEEN CONLON (CO-OWNER) |
| Authorized Official Telephone | 9529221977 |
| Authorized Official Credential | LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE SHIELD GROUP NUMBER | 07678IN | 01 |
| Street Address |
3919 W 44TH ST STE 200 |
| City | EDINA |
| State | MN |
| Zip Code | 55424-1032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508075573 | Lenny Lawrence Jennings | Psychologist | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-05-22 |
| 1558574913 | Gayle Lencowski Knopik | Counselor | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-05-08 |
| 1336352665 | Denise H. Bisanz, P.a. | Social Worker | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-05-07 |
| 1396957049 | Karen Eileen Wolfe | Counselor | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-05-04 |
| 1003037524 | Dianne Lynn Lockman | Psychologist | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-05-01 |
| 1407075401 | Kathleen Mary Conlon | Social Worker | 3919 W 44th St Ste 200, Edina, MN 55424-1032 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154824084 | Jamie Bradley | Midwife | 6240 Peacedale Avenue, Edina, MN 55424 | 2018-03-16 |
| 1467987313 | Lisa Sorensen | Psychologist | 5200 Willson Road, #445, Edina, MN 55424 | 2017-04-28 |
| 1093049348 | Harry Alvin Johnson Jr. | Plastic Surgery | 4708 Townes Road, Edina, MN 55424 | 2009-09-18 |
| 1396935219 | Michele Frances Dodds | Psychologist | 3948 West 50th St, #207, Edina, MN 55424 | 2007-07-26 |
| 1245452168 | Margo Ellen Arens | Physical Therapist | 6025 St. John's Ave., Edina, MN 55424 | 2007-05-02 |
| 1215095435 | Kristie J Anderson | Nurse Practitioner | 6905 York Ave S, Edina, MN 55424 | 2006-12-04 |
| 1821199852 | Michael T Kratz Dds Pa | Dentist | 3939 W 50th Street, #208, Edina, MN 55424 | 2006-09-25 |
| 1649747114 | Elizabeth Davin | Physician Assistant | 6905 York Ave S, Edina, MN 55424 | 2018-11-01 |
| 1245606326 | Forefront Dermatology, S.c. | Dermatology | 3916 W 50th St, Edina, MN 55424 | 2015-08-12 |
| 1316346950 | Brooke A Moss | Physician Assistant | 4100 W 50th St, Edina, MN 55424 | 2014-08-20 |
| Find all providers in zip 55424 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184195406 | Trovarti Counseling LLC | Clinic/Center | 3300 Edinborough Way Ste 55, Edina, MN 55435-5923 | 2018-12-15 |
| 1891819686 | Janet Anderson Counseling | Clinic/Center | 7400 Metro Blvd Ste 413, Edina, MN 55439-2326 | 2007-03-18 |
| 1255989489 | Health Innovations of America | Clinic/Center | 7400 Metro Blvd Ste 427, Edina, MN 55439-2359 | 2019-08-30 |
| 1316505803 | Daryn R. Rogers, Phd, Lp, LLC | Clinic/Center | 4570 W 77th St Ste 235, Edina, MN 55435-5092 | 2019-05-30 |
| 1295979664 | Twin Cities Behavioral Health, PC | Clinic/Center | 7300 Metro Blvd, Suite 635, Edina, MN 55439-2303 | 2009-04-28 |
| 1750301040 | Ted Lobby, LLC | Clinic/Center | 6600 France Ave S, # 472, Edina, MN 55435-1805 | 2006-07-20 |
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| 1851991160 | Gratia Counseling & Consulting, LLC | Clinic/Center | 2705 Bunker Lake Blvd Nw Ste 103, Andover, MN 55304-3786 | 2020-10-27 |
| 1508465147 | Piece of Mind Counseling Services, Pllc | Clinic/Center | 1122 Bemidji Ave N, Bemidji, MN 56601-2833 | 2020-10-24 |
| 1205433984 | Hopebridge Life Skills Center | Clinic/Center | 3617 E Lake St, Minneapolis, MN 55406-2148 | 2020-10-05 |
| 1275149007 | Clarity Counseling Services Pllc | Clinic/Center | 521 W Highway 2, Cohasset, MN 55721-2300 | 2020-09-17 |
| 1720693146 | Serene Therapy and Counseling Services LLC | Clinic/Center | 777 Berry St Apt 400b, Saint Paul, MN 55114-4006 | 2020-09-11 |
| 1427662592 | Threesixty, LLC | Clinic/Center | 4960 Miller Trunk Hwy # 600-b, Hermantown, MN 55811-1891 | 2020-09-04 |
| 1124639190 | Woodhaven Wellness | Clinic/Center | 3000 Carriage Dr, Hamel, MN 55340-9597 | 2020-08-13 |
| 1245840735 | Kalina Counseling Services | Clinic/Center | 120 7th St Unit 101, Two Harbors, MN 55616-1563 | 2020-08-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.