Renew Pediatric Therapy LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

RENEW PEDIATRIC THERAPY LLC

Practice address

21995 Finley CT N
Forest Lake, MN 55025-9779

Phone

(480) 529-0269

Fax

(651) 243-0305

NPI assigned

Feb 19, 2026

Last updated

Feb 19, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ellen E Van Tassel, M.A., CCC-SLPNPI 1891006599

Title

Owner

Phone

(480) 529-0269

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ellen Van Tassel, MA, CCC-SLP

  • Speech-Language Pathologist
  • Forest Lake, MN
  • NPI 1891006599
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1771459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771459200000",
    "number": "1043163926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21995 FINLEY CT N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259779",
            "telephone_number": "480-529-0269",
            "fax_number": "651-243-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21995 FINLEY CT N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259779",
            "telephone_number": "480-529-0269",
            "fax_number": "651-243-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A",
        "authorized_official_last_name": "VAN TASSEL",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-529-0269",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Porath, LICSW
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• Leona Claire Pyle, RPH
• Lori Quist, MA, LADC
• Nathan Riedeman, PHARMD
• Sarah Anne Ries, LADC
• Megan Robb, PSY.D
• Rolseth Drug Co
• Rolseth Drug Co

• Hearing and Speech Clinic/Center in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Hearing and Speech Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.