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

Divergent Path Therapy PLLC

Organization Clinic/Center · NPI 1083598205

Divergent Path Therapy PLLC is a Clinic/Center in Minneapolis, Minnesota. Registered with an NPI since 2025.

In the registry since
2025
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

4404 Nicollet Ave Apt 1
Minneapolis, MN 55419-2642
Phone: (612) 217-4890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1083598205
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shane Prijatel-Spare — Owner · (612) 217-4890
NPI enumeratedAugust 1, 2025
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025
Mailing address4404 Nicollet Ave Apt 1, Minneapolis, MN 55419-2642

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