Manzanita Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MANZANITA THERAPY, LLC

Practice address

5208 Bloomington Ave S
Minneapolis, MN 55417

Phone

(612) 246-6689

Fax

(612) 822-2216

NPI assigned

Jan 29, 2014

Organization subpart

No

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

Authorized official

Name

Melanie Alford, LICSW

Title

Owner/Therapist

Phone

(612) 246-6689

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Ryan David Feddersen-Poindexter, D.C.

  • Chiropractor
  • Minneapolis, MN
  • NPI 1194913442
  NPD (past)
• Kerry Edna McDonald, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1205928363
  NPD (past)

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1760805600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 BLOOMINGTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-246-6689",
            "fax_number": "612-822-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 BLOOMINGTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-246-6689",
            "fax_number": "612-822-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANITA THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "ALFORD",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "612-246-6689",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID MINNESOTA (MA)",
            "identifier": "1700229291",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha E Manthie, MA
• Edgar Mantilla, DDS
• Sarah Manuels, PA, MPH
• Jesse M Manunga Jr., M.D.
• Kohl M Manzanares
• Fawsiya M Maow
• Mara Rogers Speech & Language LLC
• Sasha Maraj, MD
• Collins Maranga, RN
• Timothy Maranga

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.