PORTLIGHT MENTAL HEALTH (NPI# 1841776960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841776960 |
| Entity Type | Organization |
| Organization Name | PORTLIGHT MENTAL HEALTH |
| Practice Address |
5413 Nicollet Ave # 152 Minneapolis MN 55419-1927 |
| Practice Telephone | 6125248243 |
| Mailing Telephone | 6125248243 |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |
| Authorized Official Name | MICHAEL DALY (LICENSED THERAPIST) |
| Authorized Official Telephone | 6125248243 |
| Authorized Official Credential | MA, LMFT |
| 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 |
| Street Address |
5413 NICOLLET AVE # 152 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55419-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972020329 | Michael Daly | Marriage & Family Therapist | 5413 Nicollet Ave # 152, Minneapolis, MN 55419 | 2017-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032054 | David Gregg | Internal Medicine | 5305 Humboldt Ave S, Minneapolis, MN 55419 | 2020-01-15 |
| 1518343946 | Samantha Ruth Praus | Counselor | Wellness Minneapolis, 4450 Nicollet Ave. S., Minneapolis, MN 55419 | 2015-08-07 |
| 1679919104 | Morgan Supinski | Occupational Therapist | 5748 Clinton Ave, Minneapolis, MN 55419 | 2013-05-10 |
| 1720358021 | Jeremy Zellmann | Pharmacist | 6001 Mogan Avenue South, Minneapolis, MN 55419 | 2012-01-04 |
| 1003108895 | Nicollet Dental | Dentist | 6101 Nicollet Ave. So., Minneapolis, MN 55419 | 2011-05-11 |
| 1194056812 | Laura J. Johnson | Social Worker | 410 E 48th St Ste 2, Minneapolis, MN 55419 | 2010-01-20 |
| 1992934392 | Morningsong Therapy Center Inc | Clinic/Center | 25 W. Diamond Lake Road, Minneapolis, MN 55419 | 2009-07-07 |
| 1619118775 | Dr. David Mckay, Dds LLC | Dentist | 4800 Nicollet Ave. S., Minneapolis, MN 55419 | 2009-03-18 |
| 1750553343 | Alex B Lanning | Chiropractor | 5415 Nicollet Ave, Minneapolis, MN 55419 | 2008-03-24 |
| 1679743819 | Lisa Karen Hill | Marriage & Family Therapist | 25 W. Diamond Lk Rd, Mpls, MN 55419 | 2008-03-04 |
| Find all providers in zip 55419 | ||||
| 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 |
|---|---|---|---|---|
| 1205433984 | Hopebridge Life Skills Center | Clinic/Center | 3617 E Lake St, Minneapolis, MN 55406-2148 | 2020-10-05 |
| 1801404637 | Golden Health LLC | Clinic/Center | 3601 Phillips Pkwy Apt 116, Minneapolis, MN 55426-3800 | 2020-07-17 |
| 1720562812 | Axisspoint Inc | Clinic/Center | 2021 E Hennepin Ave Ste 193, Minneapolis, MN 55413-1773 | 2018-09-24 |
| 1295213759 | Kathleen Healthcare Center | Clinic/Center | 2647 Bloomington Ave, Minneapolis, MN 55407-1187 | 2018-08-06 |
| 1730672106 | Koru Holistic Counseling | Clinic/Center | 314 Clifton Ave Ste 10, Minneapolis, MN 55403-3384 | 2018-06-11 |
| 1043700800 | Roots Therapy & Consulting LLC | Clinic/Center | 2920 Bryant Ave S Ste 112, Minneapolis, MN 55408-2332 | 2018-05-16 |
| 1093216848 | Cure Care Psychotherapy LLC | Clinic/Center | 730 E 38th St Ste 201, Minneapolis, MN 55407-5235 | 2018-02-27 |
| 1801308077 | Nicole J Wolf Phd Lp | Clinic/Center | 4749 Chicago Ave Ste 1a, Minneapolis, MN 55407-4181 | 2017-10-27 |
| 1386953974 | Water's Edge Psychotherapy, LLC | Clinic/Center | 3617 45th Ave S, Minneapolis, MN 55406-2928 | 2010-09-29 |
| 1992934392 | Morningsong Therapy Center Inc | Clinic/Center | 25 W. Diamond Lake Road, Minneapolis, MN 55419 | 2009-07-07 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55419 |
Please comment or provide details below to improve the information on PORTLIGHT MENTAL HEALTH.
| 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.