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NPI Code Detail

MEDICARE: FAYA THERAPY LLC

MEDICARE: FAYA THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134072309
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAYA THERAPY LLC
Provider Business Mailing Address
First Line : 1121 JACKSON ST NE STE 100
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3051
Country : US
Telephone Number : 612-293-7353
Fax Number :
Provider Business Practice Location Address
First Line : 1121 JACKSON ST NE STE 100
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3051
Country : US
Telephone Number : 612-293-7353
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KIFAYA BISHOP
Credential : MS, LPCC
Telephone Number : 612-293-7353
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “FAYA THERAPY LLC ” Practice Location

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