NPIMap

Organization Active NPI

Supportive Journeys Psychotherapy, LLC

  • Clinical Social Worker
  • St. Paul, MN
National Provider Identifier
1629404074
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16425 Issued in MN
Legal business name
SUPPORTIVE JOURNEYS PSYCHOTHERAPY, LLC
Practice address
1678 Selby Avenue
St. Paul, MN 55104
Phone
(651) 226-7445
NPI assigned
Sep 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Ms. Rebecca Lynn Pihl, LICSW
Title
Clinical Social Worker
Phone
(651) 226-7445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 16425 MN Primary

Addresses

Primary practice location

1678 Selby Avenue
St. Paul, MN 55104

Mailing address

3340 37TH Avenue South
Minneapolis, MN 55406
Phone (651) 226-7445

National Provider Directory

National Provider Directory

Locations

1678 Selby Ave
Saint Paul, MN 55104
Phone (651) 226-7445

Practitioners & affiliated clinicians

Practitioners 8

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": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1629404074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 37TH AVENUE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55406",
            "telephone_number": "651-226-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 SELBY AVENUE",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-226-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE JOURNEYS PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "PIHL",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "651-226-7445",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.