Provider Demographics
NPI:1750028866
Name:THE RECOVERY THERAPIST LLC
Entity type:Organization
Organization Name:THE RECOVERY THERAPIST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:KASNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:415-290-4054
Mailing Address - Street 1:7301 OHMS LN STE 450
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2339
Mailing Address - Country:US
Mailing Address - Phone:952-831-2000
Mailing Address - Fax:
Practice Address - Street 1:1731 WORDSWORTH AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2733
Practice Address - Country:US
Practice Address - Phone:415-779-5506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health