Divergent Path Therapy PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DIVERGENT PATH THERAPY PLLC

Practice address

4404 Nicollet Ave Apt 1
Minneapolis, MN 55419-2642

Phone

(612) 217-4890

NPI assigned

Aug 1, 2025

Organization subpart

No

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

Authorized official

Name

Shane Prijatel-SpareNPI 1548846488

Title

Owner

Phone

(612) 217-4890

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.

• Shane Prijatel-Spare

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1548846488
  NPD Authorized official

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1083598205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 NICOLLET AVE APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554192642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 NICOLLET AVE APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554192642",
            "telephone_number": "612-217-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGENT PATH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "PRIJATEL-SPARE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-217-4890"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Gordon Disner, PHD, LP
• Rebecca Disomma, MD
• Kristin Marit Disori, M.D.
• Ruwan R Dissanayake, MD
• Joan Eve Distler
• Diverse Home Health Care
• Diverse Mental Health Response LLC
• Diversified Home Care Inc
• Diversity Union Group Home Limited Liability Company
• Carmen N Divertie, MD

• Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.