Therapy Distinct LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

THERAPY DISTINCT LLC

Practice address

4786 N Sandra J Cir
Palmer, AK 99645-7912

Phone

(907) 231-6151

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Chelsa Dorman, LCSW

Title

Sole Member

Phone

(907) 231-6151

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1700470663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4786 N SANDRA J CIR",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457912",
            "telephone_number": "907-231-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4786 N SANDRA J CIR",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457912",
            "telephone_number": "907-231-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY DISTINCT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "DORMAN",
        "authorized_official_first_name": "CHELSA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "907-231-6151",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Mental Health Co-Op LLC
• Marcus Charles Thiemann, DO
• Anne McNeely Thomas, PT
• Shelly Joan Thomas, LMFT
• Amber Thompson
• Kimberly Patricia Thompson

• Adult Mental Health Clinic/Center in Palmer, AK
• Providers in Palmer, AK by specialty
• Adult Mental Health Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.