Organization Active NPI

Interpersonal Mental Health LLC

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1376392613
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
INTERPERSONAL MENTAL HEALTH LLC
Practice address
6 E Diamond Lake Rd
Minneapolis, MN 55419-1923
Phone
(612) 590-8070
NPI assigned
May 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Stanley F Theiele, LMFT
Title
Owner
Phone
(612) 590-8070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

6 E Diamond Lake Rd
Minneapolis, MN 55419-1923

Mailing address

6 E Diamond Lake Rd
Minneapolis, MN 55419-1923
Phone (612) 590-8070

Other practice location 1

8700 W 36th St Ste 245
Saint Louis Park, MN 55426-3906
Phone (612) 590-8070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240705002916 MN Part B Supplier - Clinic/Group Practice 8224572839 Receives reassigned benefits from 1 practitioner
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

8700 W 36th St
Ste 245
Saint Louis Park, MN 55426
Phone (612) 590-8070

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": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1376392613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E DIAMOND LAKE RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191923",
            "telephone_number": "612-590-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E DIAMOND LAKE RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191923",
            "telephone_number": "612-590-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 W 36th St Ste 245",
            "address_purpose": "LOCATION",
            "city": "Saint Louis Park",
            "state": "MN",
            "postal_code": "554263906",
            "country_code": "US",
            "telephone_number": "612-590-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERPERSONAL MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "THEIELE",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-590-8070",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "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 May 17, 2024; 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.