Organization Active NPI

Pure Therapy, LLC

  • Adult Mental Health Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1124702634
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PURE THERAPY, LLC
Practice address
1409 Willow St Ste 201
Minneapolis, MN 55403-3254
Phone
(612) 562-9021
Fax
(866) 535-8560
NPI assigned
Jun 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Kristen Noel Paradise, LPCCNPI 1740814755
Title
Psychotherapist
Phone
(612) 227-4597

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1409 Willow St Ste 201
Minneapolis, MN 55403-3254

Mailing address

1409 Willow St Ste 201
Minneapolis, MN 55403-3254
Phone (612) 562-9021

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1124702634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST STE 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033254",
            "telephone_number": "612-562-9021",
            "fax_number": "866-535-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST STE 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033254",
            "telephone_number": "612-562-9021",
            "fax_number": "866-535-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "PARADISE",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "612-227-4597",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.