Twin Cities Recovery Gym & Wellness Center LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

TWIN CITIES RECOVERY GYM & WELLNESS CENTER LLC

Practice address

2912 N 2ND St
Minneapolis, MN 55411-1606

Phone

(612) 720-5599

NPI assigned

Jul 21, 2021

Organization subpart

No

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

Authorized official

Name

Crystal Rae Hill, MBA, CPRS

Title

Chief Executive Officer

Phone

(612) 720-5599

Specialties & licenses 7

Addresses

Other names 1

• Twin Cities Wellness Center & Recovery Gym Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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

• Jennifer Rebecca Miller, MSW, LICSW

  • Clinical Social Worker
  • Brooklyn Center, MN
  • NPI 1366743916
  Medicare reassignment Care Compare group NPD
• James Michael Walch, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1649358797
  Medicare reassignment Care Compare group NPD
• Cristine Marie Haider, LPCC

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1376406298

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Jacob Thomas Minnig, MA, LPCC, LADC

  • Professional Counselor
  • Eagan, MN
  • NPI 1114660966

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Jenna Erickson

  • Social Worker
  • Minneapolis, MN
  • NPI 1770379281
  NPD

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1487227161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15392 60TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464541",
            "telephone_number": "612-720-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 N 2ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554111606",
            "telephone_number": "612-720-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES RECOVERY GYM & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "612-720-5599",
        "authorized_official_credential": "MBA, CPRS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NAS",
            "affiliation": "N",
            "endpointDescription": "1 TB Buffalo NAS 256 encryption key",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NAS",
            "address_1": "2912 N 2nd St",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554111606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Twin Cities Wellness Center & Recovery Gym",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.