Regina Cadwallader

Key facts

NPI

1033545348

Entity type

Individual (NPI type 1)

Primary specialty

Marriage & Family Therapist 106H00000X

License

3431 (MN)

Practice address

5232 Kyler Ave NE Ste C
Albertville, MN 55301-4634

Phone

(763) 260-5313

NPI assigned

Sep 18, 2013

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Orthopedic & Spine Therapy of Albertville, LLC Physical Therapist · Albertville, MN · NPI 1235674037
  NPD MARRIAGE & FAMILY THERAPIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2023.

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1033545348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5232 KYLER AVE NE STE C",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553014634",
            "telephone_number": "763-260-5313",
            "fax_number": "833-599-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 KYLER AVE NE STE C",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553014634",
            "telephone_number": "763-260-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADWALLADER",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "250-228",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Albertville, MN · Marriage & Family Therapist in Minnesota