Individual provider Active NPI

Patricia Lea Beaudoin, LMFT

  • Marriage & Family Therapist
  • Northfield, MN
National Provider Identifier
1013621770
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4160 Issued in MN
Practice address
570 Professional Dr
Northfield, MN 55057-2756
Phone
(507) 301-3412
NPI assigned
Jan 9, 2023
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4160 MN Primary

Addresses

Primary practice location

570 Professional Dr
Northfield, MN 55057-2756

Mailing address

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chromebook Health Information Exchange (HIE) Secure Base Counseling Center LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809003413 MN Practitioner - Marriage and Family Therapist 7012455959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashlee SecordGroup PAC ID 1355719287, 11 clinicians

Practice addresses (Care Compare)

11990 Portland Ave
Burnsville, MN 55337-1516
Phone (612) 568-6050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4160MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ashlee Secord Marriage & Family Therapist CurrentSince Jun 1, 2025 Accepting new patients
Secure Base Counseling Center LLC Marriage & Family Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

11990 Portland Ave
Burnsville, MN 55337
Phone (612) 439-1100

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1013621770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-301-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-301-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOIN",
        "first_name": "PATRICIA",
        "middle_name": "LEA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chromebook",
            "affiliation": "Y",
            "endpointDescription": "Laptop",
            "affiliationName": "Secure Base Counseling Center LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "570 Professional Dr",
            "city": "Northfield",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550572756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

Verify at the official NPI Registry.