Organization Active NPI

Therapy Haven Support Inc

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1417834151
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THERAPY HAVEN SUPPORT INC
Practice address
5275 Edina Industrial Blvd Ste 106
Edina, MN 55439-2915
Phone
(651) 253-7764
NPI assigned
Aug 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Holli EngelhartNPI 1912396490
Title
Licsw, Owner
Phone
(651) 253-7764

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

5275 Edina Industrial Blvd Ste 106
Edina, MN 55439-2915

Mailing address

5275 Edina Industrial Blvd Ste 106
Edina, MN 55439-2915
Phone (651) 253-7764

National Provider Directory

National Provider Directory

Locations

5275 Edina Industrial Blvd
Ste 106
Edina, MN 55439
Phone (651) 253-7764

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": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1417834151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 106",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392915",
            "telephone_number": "651-253-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 EDINA INDUSTRIAL BLVD STE 106",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392915",
            "telephone_number": "651-253-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY HAVEN SUPPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "ENGELHART",
        "authorized_official_first_name": "HOLLI",
        "authorized_official_title_or_position": "LICSW, OWNER",
        "authorized_official_telephone_number": "651-253-7764"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.