VLW LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

3061 Issued in MN

Legal business name

VLW LLC

Practice address

4255 Pheasant Ridge Dr NE Ste 412
Blaine, MN 55449-5066

Phone

(612) 799-6652

NPI assigned

Aug 9, 2018

Organization subpart

No

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

Authorized official

Name

Amanda Adell Wirth, LMFTNPI 1215324074

Title

Ceo

Phone

(612) 799-6652

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Amanda Adell Wirth, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1215324074
  NPD Authorized official

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1336628478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8578 DUNKIRK CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496789",
            "telephone_number": "612-799-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "612-799-6652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7077 Northland Cir N Ste 330",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554281567",
            "country_code": "US",
            "telephone_number": "612-799-6652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VLW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "WIRTH",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ADELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-799-6652",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "3061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5724462",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victory Transport North
• Vision World Inc
• Visionworks, Inc.
• Vital Agency LLC
• Suzette Vizenor
• Volunteers of America of Minnesota
• Ryan William Waddell, D.C.
• Kasey Lynn Wade
• Wal-Mart Stores, Inc.
• Wal-Mart Stores, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Blaine, MN
• Providers in Blaine, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.