Center for Women'S Group Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC0021 Issued in MN

Legal business name

CENTER FOR WOMEN'S GROUP THERAPY

Practice address

11900 Wayzata Blvd
Ste 200
Minnetonka, MN 55305-2031

Phone

(612) 701-0066

Fax

(952) 546-1308

NPI assigned

May 4, 2015

Organization subpart

No

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

Authorized official

Name

Ilise Katz, LPCC

Title

Gen PTR

Phone

(612) 701-0066

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Joan W. Lally, LICSW

  • Clinical Social Worker
  • Minnetonka, MN
  • NPI 1477531424
  NPD (past)
• Jill Michele Stiber, MSSW, LICSW, BCD

  • Clinical Social Worker
  • Minnetonka, MN
  • NPI 1861560328
  NPD (past)

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1831576453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 PLEASANT AVE",
            "address_2": "STE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091279",
            "telephone_number": "612-802-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 WAYZATA BLVD",
            "address_2": "STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052031",
            "telephone_number": "612-701-0066",
            "fax_number": "952-546-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR WOMEN'S GROUP THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "ILISE",
        "authorized_official_title_or_position": "GEN PTR",
        "authorized_official_telephone_number": "612-701-0066",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC0021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Catanzaro
• James Joseph Cavanaugh, LADC
• Susan Elaine Cave, NP
• CDC Centers
• CDC Centers, Inc
• Carole Gail Cera, LICSW
• Becky Cervenka
• Sonja Chafin, RN,CFNP
• Nathan A Champine, PA-C
• Nathan Michael Champion, N.D.

• Professional Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.