MEDICARE: QUILTED PSYCHOTHERAPY 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518814656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUILTED PSYCHOTHERAPY LLC

Provider Business Mailing Address
First Line	:	2324 UNIVERSITY AVE W STE 120
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1854
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2324 UNIVERSITY AVE W STE 120
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1854
Country	:	US
Telephone Number	:	651-564-7901
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA WESLEY
Credential	:
Telephone Number	:	651-564-7901

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	04/12/2026

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