NPIMap

Organization Active NPI

Wellness Therapy Center LLC

  • Clinical Social Worker
  • Brooklyn Park, MN
National Provider Identifier
1114653169
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WELLNESS THERAPY CENTER LLC
Practice address
4707 107TH Ave N
Brooklyn Park, MN 55443-5801
Phone
(612) 516-7382
NPI assigned
Jul 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Authorized official

Name
Hanaan Yusuf, OWNERNPI 1942829957
Title
President/ Owner
Phone
(612) 516-7382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4707 107TH Ave N
Brooklyn Park, MN 55443-5801

Mailing address

4707 107TH Ave N
Brooklyn Park, MN 55443-5801
Phone (612) 516-7382

Other names 1

  • Wellness Therapy Center LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659139200000",
    "number": "1114653169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 107TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435801",
            "telephone_number": "612-516-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 107TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435801",
            "telephone_number": "612-516-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A",
        "authorized_official_last_name": "YUSUF",
        "authorized_official_first_name": "HANAAN",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "612-516-7382",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Therapy Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; 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.