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Organization
BIRCHBARK PLAY THERAPY
Active
Organization
BIRCHBARK PLAY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MARIE MASTERS MA, LPCC-S (CHILD THERAPIST)
(612) 578-2502
Entity
Organization
Contact information
Practice address
7400 LYNDALE AVE S STE 160, MINNEAPOLIS, MN 55423-4142
(612) 578-2502
Mailing address
6045 COLUMBUS AVE, MINNEAPOLIS, MN 55417-3109
(612) 578-2502
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619375250
—
MN
Enumeration date
04/04/2025
Last updated
04/04/2025
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