Provider Demographics
NPI:1285272633
Name:A GOOD PLACE THERAPY
Entity type:Organization
Organization Name:A GOOD PLACE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:651-245-1195
Mailing Address - Street 1:649 ARLO LN
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-5506
Mailing Address - Country:US
Mailing Address - Phone:651-245-1195
Mailing Address - Fax:
Practice Address - Street 1:7029 20TH AVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MN
Practice Address - Zip Code:55038-9737
Practice Address - Country:US
Practice Address - Phone:651-245-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty