Transformational Psychotherapy LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

TRANSFORMATIONAL PSYCHOTHERAPY LLC

Practice address

249 Water St RM 201
Excelsior, MN 55331-1824

Phone

(612) 710-3874

NPI assigned

Jul 19, 2019

Last updated

Jul 19, 2019By 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

Karen Ilvedson, MA, LPCCNPI 1508423435

Title

Psychotherapist, Owner

Phone

(612) 710-3874

Specialties & licenses 2

Addresses

Locations

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.

• Karen Ilvedson, LPCC

  • Mental Health Counselor
  • Excelsior, MN
  • NPI 1508423435
  NPD Authorized official

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1114570033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5385 SHADY HILLS CIR",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553319157",
            "telephone_number": "612-710-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 WATER ST RM 201",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553311824",
            "telephone_number": "612-710-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIONAL PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "ILVEDSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST, OWNER",
        "authorized_official_telephone_number": "612-710-3874",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Tobin
• Town Dental, PA
• Town Dental, PA
• Joanna Trabing, M.A., CCC-SLP
• Makenna Tramp
• Sondra Lee Traylor, D.C., L.AC.
• Kelly Trombley, M.A. CCC-SLP
• Alex P Twenge
• Tomasina Marie Uttecht
• Maureen Pauly Utz, MD

• Adult Mental Health Clinic/Center in Excelsior, MN
• Providers in Excelsior, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.