WILLOW BAY THERAPY, LLC
NPI 1104354406
Clinic/Center - Mental Health (Including Community Mental Health Center) in Plymouth, MN

Q: What is Willow Bay Therapy, LLC's NPI number?

The NPI number for Willow Bay Therapy, LLC is 1104354406. It was assigned to this organization in the NPPES registry on May 31, 2017.

Q: What is Willow Bay Therapy, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since May 31, 2017

12805 HIGHWAY 55 STE 216, PLYMOUTH, MN 55441(612) 440-1450(612) 524-5563 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 29, 2020, Mar 21, 2018, May 31, 2017 (3 updates tracked since 2017).

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About Willow Bay Therapy, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW BAY THERAPY, LLC (NPI 1104354406) is a healthcare organization registered as a mental health (including community mental health center) in Plymouth, Minnesota and active in the NPI registry since May 2017. The organization maintains a secondary practice location in Minneapolis and lists Joanna Lynn Kelly, Owner/psychotherapist, as its authorized official.

NPPES Registry Identity

NPI1104354406

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameWILLOW BAY THERAPY, LLC

Location Address12805 HIGHWAY 55 STE 216Plymouth, MN 55441-3859

Mailing Address3933 Bloomington AveMinneapolis, MN 55407-2843 · (612) 961-1015 · Fax (612) 524-5563

Phone(612) 440-1450

Fax(612) 524-5563

Organization SubpartNo

Authorized OfficialJoanna Lynn KellyOwner/psychotherapist · (612) 961-1015

Enumeration DateMay 31, 2017

Last NPPES UpdateFebruary 23, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2026

✔ NPI 1104354406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

License✔ Licensed in MN · 3192

Also ListedOccupational Therapist · Mental HealthTaxonomy 225XM0800X

Also ListedOccupational Therapist · PediatricsTaxonomy 225XP0200X

12805 HIGHWAY 55 STE 216, Plymouth, MN 55441

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Secondary Practice Location 1

Location 13441 Cedar Ave SMINNEAPOLIS, MN 55407-2336 · Phone (612) 440-1450 · Fax (612) 524-5563

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willow Bay Therapy, LLC's NPI number?

The NPI number for Willow Bay Therapy, LLC is 1104354406. It was assigned to this organization in the NPPES registry on May 31, 2017.

Where is Willow Bay Therapy, LLC located?

Willow Bay Therapy, LLC is located at 12805 Highway 55 Ste 216, Plymouth, MN 55441. The listed phone number is (612) 440-1450.

What is Willow Bay Therapy, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Willow Bay Therapy, LLC was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.