Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Authentic Self Therapy PLLC

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1255013504

Authentic Self Therapy PLLC is a Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Cloud, Minnesota. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

103 Doctors Park
Saint Cloud, MN 56303-1207
Phone: (320) 855-6557
Fax: (320) 238-7456
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X

Record details

NPI number1255013504
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicolette Johnson — Therapist · (320) 855-6557
NPI enumeratedAugust 7, 2023
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025
Mailing address103 Doctors Park, Saint Cloud, MN 56303-1207

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