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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SPACE TO BE LLC
NPI 1689591273
Social Worker - Clinical in Minneapolis, MN

Active since July 02, 2026
2601 HUMBOLDT AVE N, MINNEAPOLIS, MN 55411(612) 644-8390 Get Directions Write a Review

NPPES record added: July 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Space To Be Llc NPPES

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

SPACE TO BE LLC (NPI 1689591273) is a healthcare organization registered as a clinical in Minneapolis, Minnesota and active in the NPI registry since July 2026. The organization lists Maia Shanae Jackson, Psychotherapist, as its authorized official.

NPPES Registry Identity

NPI1689591273
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameSPACE TO BE LLC
Location Address2601 HUMBOLDT AVE NMinneapolis, MN 55411-2041
Mailing Address2601 Humboldt Ave NMinneapolis, MN 55411-2041
Phone(612) 644-8390
Organization SubpartNo
Authorized OfficialMaia Shanae JacksonPsychotherapist · (612) 644-8390
Enumeration DateJuly 2, 2026
NPPES CertifiedJuly 2, 2026
✔ NPI 1689591273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2601 HUMBOLDT AVE N, Minneapolis, MN 55411
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 Space To Be LLC's NPI number?

The NPI number for Space To Be LLC is 1689591273. It was assigned to this organization in the NPPES registry on July 2, 2026.

Where is Space To Be LLC located?

Space To Be LLC is located at 2601 Humboldt Ave N, Minneapolis, MN 55411. The listed phone number is (612) 644-8390.

What is Space To Be LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Space To Be LLC was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.