Silver Birch Therapy PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2962 Issued in MN

Legal business name

SILVER BIRCH THERAPY PLLC

Practice address

905 Stanley Ave
Cloquet, MN 55720-3186

Phone

(612) 876-6586

Fax

(185) 851-5862

NPI assigned

Apr 6, 2018

Organization subpart

No

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

Authorized official

Name

Amy Vredenburgh, MA, LMFTNPI 1568858470

Title

Owner

Phone

(612) 876-6586

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Amy Vredenburgh, M.A., L.M.F.T.

  • Marriage & Family Therapist
  • Cloquet, MN
  • NPI 1568858470
  NPD Authorized official

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1659878742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 SW GEMINI DR",
            "address_2": "PMB 14034",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085842",
            "telephone_number": "612-876-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 STANLEY AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203186",
            "telephone_number": "612-876-6586",
            "fax_number": "185-851-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER BIRCH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "VREDENBURGH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-876-6586",
        "authorized_official_credential": "MA, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elenore C Schoenfeld, LICSW
• Laura Lynn Schuster
• Janette Mary Setterquist, RN
• Terry Michael Setterquist, DC
• Kyle Siiter
• Alexa Mary Sinner
• Tawny Lee Smith-Savage, LCSW LADC
• Jeremy Clinton Smith, RD
• Katrina Reanne Smith
• Sound Mind Behavioral Health, PLLC

• Marriage & Family Therapist in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Marriage & Family Therapist in Minnesota

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