Healthcare Provider Details

I. General information

NPI: 1104782929
Provider Name (Legal Business Name): STAY AWHILE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13394 BRADLEY BLVD
BECKER MN
55308-9534
US

IV. Provider business mailing address

5123 W 98TH ST # 2036
MINNEAPOLIS MN
55437-2040
US

V. Phone/Fax

Practice location:
  • Phone: 763-330-0869
  • Fax:
Mailing address:
  • Phone: 763-330-0869
  • Fax: 952-209-9736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAMIE J CHAPIN
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LICSW
Phone: 763-330-0869