NPIMap

Organization Active NPI

Kenwood Therapy Center, LLC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1144271230
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KENWOOD THERAPY CENTER, LLC
Practice address
2809 Wayzata Blvd
Minneapolis, MN 55405-2131
Phone
(612) 377-9190
Fax
(612) 374-4498
NPI assigned
May 13, 2006
Last updated
Dec 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Dr. Walter H Bera, PHD, LPNPI 1265488878
Title
Director
Phone
(612) 377-9190

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2809 Wayzata Blvd
Minneapolis, MN 55405-2131

Mailing address

2809 Wayzata Blvd
Minneapolis, MN 55405-2131
Phone (612) 377-9190

National Provider Directory

National Provider Directory

Locations

2809 Wayzata Blvd
Minneapolis, MN 55405
Phone (612) 377-9190

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1144271230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052131",
            "telephone_number": "612-377-9190",
            "fax_number": "612-374-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052131",
            "telephone_number": "612-377-9190",
            "fax_number": "612-374-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENWOOD THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "BERA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-377-9190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "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 Dec 28, 2007; 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.