Healthcare Provider Details

I. General information

NPI: 1750028866
Provider Name (Legal Business Name): THE RECOVERY THERAPIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 WORDSWORTH AVE
SAINT PAUL MN
55116-2733
US

IV. Provider business mailing address

7301 OHMS LN STE 450
EDINA MN
55439-2339
US

V. Phone/Fax

Practice location:
  • Phone: 415-779-5506
  • Fax:
Mailing address:
  • Phone: 952-831-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLE ANNE KASNER
Title or Position: OWNER
Credential: LMFT
Phone: 415-290-4054