The Healing Hideout LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE HEALING HIDEOUT LLC

Practice address

4951 77TH St W # 1
Edina, MN 55435-4802

Phone

(952) 239-1121

NPI assigned

Nov 25, 2024

Organization subpart

No

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

Authorized official

Name

Bradley CrnobrnaNPI 1366838781

Title

Owner

Phone

(952) 239-1121

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 7

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

• Bradley Crnobrna, LICSW, LADC

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1366838781
  Medicare reassignment NPD Authorized official
• Faye Katherine Foote, MA, LPCC

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1174900773
  Medicare reassignment Care Compare group NPD
• Louisa Lienke, MA, LMFT

  • Marriage & Family Therapist
  • Woodbury, MN
  • NPI 1134513666
  Medicare reassignment Care Compare group NPD
• Jessica Thurmer, MSW, LGSW, LADC

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1588384713
  Medicare reassignment Care Compare group NPD
• Matthew Johnson, MA LPCC

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1265764641
  Medicare reassignment NPD
• Erin Pash, LMFT

  • Marriage & Family Therapist
  • Woodbury, MN
  • NPI 1356731368
  NPD (past)
• Lucas Arthur Volini, DMFT, LMFT

  • Marriage & Family Therapist
  • Chaska, MN
  • NPI 1457795361
  NPD (past)

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1922824879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 77TH ST W # 1",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354802",
            "telephone_number": "952-239-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 77TH ST W # 1",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354802",
            "telephone_number": "952-239-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEALING HIDEOUT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "CRNOBRNA",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-239-1121"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Edina, MN
• Providers in Edina, 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 Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.