Organization Active NPI

Know Thyself, PLLC

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1316643554
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KNOW THYSELF, PLLC
Practice address
10505 Wayzata Blvd Ste 203-3
Minnetonka, MN 55305-1502
Phone
(763) 242-3261
Fax
(866) 318-3073
NPI assigned
Jan 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Authorized official

Name
Melissa Raatz, LICSWNPI 1942778022
Title
President
Phone
(763) 242-3261

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

10505 Wayzata Blvd Ste 203-3
Minnetonka, MN 55305-1502

Mailing address

417 Rucks Farm Rd
Delano, MN 55328-8837
Phone (763) 242-3261

Other identifiers 1

IdentifierTypeStateIssuer
1710295001MedicaidMN

Other names 1

  • KNOW THYSELF HEALING & THERAPY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230509000917 MN Part B Supplier - Clinic/Group Practice 9436514817 Receives reassigned benefits from 3 practitioners
Practice locations: Minnetonka, MN

National Provider Directory

National Provider Directory

Locations

10505 Wayzata Blvd
Ste 2033
Minnetonka, MN 55305
Phone (612) 269-6578

Practitioners & affiliated clinicians

Practitioners 5

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": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1316643554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 RUCKS FARM RD",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553288837",
            "telephone_number": "763-242-3261",
            "fax_number": "866-318-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 WAYZATA BLVD STE 203-3",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051502",
            "telephone_number": "763-242-3261",
            "fax_number": "866-318-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOW THYSELF, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "RAATZ",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-242-3261",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710295001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KNOW THYSELF HEALING & THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.