Provider Demographics
NPI:1235856691
Name:AURORA THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:AURORA THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE/FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:AREND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, RPT
Authorized Official - Phone:651-705-6525
Mailing Address - Street 1:1115 SETTLERS AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8382
Mailing Address - Country:US
Mailing Address - Phone:651-757-5354
Mailing Address - Fax:
Practice Address - Street 1:225 2ND ST N STE 105
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5000
Practice Address - Country:US
Practice Address - Phone:651-705-6525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1033523170OtherNPI1