Healthcare Provider Details

I. General information

NPI: 1972396851
Provider Name (Legal Business Name): NESTING SPACE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38868 12TH AVE # 1094
NORTH BRANCH MN
55056-6658
US

IV. Provider business mailing address

12755 EAGLE RIDGE DR
BURNSVILLE MN
55337-3583
US

V. Phone/Fax

Practice location:
  • Phone: 952-239-7834
  • Fax:
Mailing address:
  • Phone: 952-239-7834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAMBER PEERBOOM
Title or Position: CO-FOUNDER
Credential:
Phone: 952-239-7834