Active NPI
Sharon R Fries, M.A., L.M.F.T.
- Marriage & Family Therapist
- Roseville, MN
National Provider Identifier
1043388341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0938
- Practice address
- 2233 Hamline Ave N
Suite 609
Roseville, MN 55113-5009 - Phone
- (651) 230-0492
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0938 | MN | Primary |
Addresses
Primary practice location
2233 Hamline Ave N
Suite 609
Roseville, MN 55113-5009
Mailing address
1068 Lake St S
Suite 109
Forest Lake, MN 55025-2639
Phone (651) 230-0492
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 275K4LI | Other | MN | BLUE CROSS BLUE SHIELD |
| 1601130-00 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0938 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1043388341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "SUITE 109",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-230-0492",
"fax_number": "651-982-6035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2233 HAMLINE AVE N",
"address_2": "SUITE 609",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551135009",
"telephone_number": "651-230-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIES",
"first_name": "SHARON",
"middle_name": "R",
"credential": "M.A., L.M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "0938",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "275K4LI",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1601130-00",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.