Active NPI
Soulspire, LLC
- Clinic/Center
- Minnetonka, MN
National Provider Identifier
1316731599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- SOULSPIRE, LLC
- Practice address
- 17508 Minnetonka Blvd
Minnetonka, MN 55345-1007 - Phone
- (763) 234-4876
- NPI assigned
- Apr 4, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan Powers Olson
- Title
- Organizer
- Phone
- (763) 234-4876
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
17508 Minnetonka Blvd
Minnetonka, MN 55345-1007
Mailing address
17508 Minnetonka Blvd
Minnetonka, MN 55345-1007
Phone (763) 234-4876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
17508 Minnetonka Blvd
Minnetonka, MN 55345
Phone (612) 524-8119
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Minnetonka, MN
- NPI 1053325175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743724800000",
"number": "1316731599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17508 MINNETONKA BLVD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553451007",
"telephone_number": "763-234-4876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17508 MINNETONKA BLVD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553451007",
"telephone_number": "763-234-4876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOULSPIRE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-04",
"last_updated": "2025-04-04",
"certification_date": "2025-04-04",
"status": "A",
"authorized_official_last_name": "POWERS OLSON",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "ORGANIZER",
"authorized_official_telephone_number": "763-234-4876",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Apr 4, 2025; 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.