Individual provider Active NPI

Catherine Loucile Moudry, LMFT

  • Marriage & Family Therapist
  • Willmar, MN
National Provider Identifier
1023311826
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2096 Issued in MN
Practice address
1125 6TH St SE
Willmar, MN 56201-4675
Phone
(320) 235-4613
Fax
(320) 235-9384
NPI assigned
Dec 16, 2010
Last updated
Dec 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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 2096 MN Primary

Addresses

Primary practice location

1125 6TH St SE
Willmar, MN 56201-4675

Mailing address

1125 6TH St SE
Willmar, MN 56201-4675
Phone (320) 235-4613

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
I20240104003565 MN Practitioner - Marriage and Family Therapist 5496106312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2096MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Centers CurrentSince Jan 1, 2024 Accepting new patients

Locations

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

Organizations & group practices 1

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": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1023311826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613",
            "fax_number": "320-235-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613",
            "fax_number": "320-235-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUDRY",
        "first_name": "CATHERINE",
        "middle_name": "LOUCILE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.