Cedar Healing Service LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

CEDAR HEALING SERVICE LLC

Doing business as

Cedar Healing Service LLC

Practice address

121 83Rd Ave NE Apt 208
Fridley, MN 55432-1883

Phone

(612) 600-7985

NPI assigned

Jan 29, 2025

Organization subpart

No

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

Authorized official

Name

Derartu Ahmed

Title

Owner

Phone

(612) 600-7985

Specialties & licenses 4

Addresses

Other names 1

• Cedar Healing Service LLC Doing business as

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1720891203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 83RD AVE NE APT 208",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 83RD AVE NE APT 208",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321883",
            "telephone_number": "612-600-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR HEALING SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "DERARTU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-600-7985"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Healing Service LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charlette Kay Carlotto, LICSW
• Kevin Gordon Carlson, LPCC, LADC
• Patrick David Carlson, D.P.T
• Carli Carrimon, LADC
• Katelyn Marie Cayton, PT, DPT
• Amy Cedar
• Wanda L Cerling, PHYSICAL THERAPIST
• Cham Clinic
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• Early Intervention Provider Agency in Fridley, MN
• Providers in Fridley, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.