Active NPI
Cindy Frederick, LMFT
- Marriage & Family Therapist
- Lakeville, MN
National Provider Identifier
1043489065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1536
- Practice address
- 7580 160TH St W
Lakeville, MN 55044-8348 - Phone
- (952) 898-1133
- Fax
- (952) 435-6797
- NPI assigned
- Feb 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LAMFT 1536 | MN | |
| Marriage & Family Therapist | 106H00000X | 1536 | MN | Primary |
Addresses
Primary practice location
7580 160TH St W
Lakeville, MN 55044-8348
Mailing address
1500 McAndrews Road West #242
Life Balance Therapy, LLC
Burnsville, MN 55337
Phone (612) 351-2820
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAMFT 1536 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508976000000",
"number": "1043489065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 MCANDREWS ROAD WEST #242",
"address_2": "LIFE BALANCE THERAPY, LLC",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "55337",
"telephone_number": "612-351-2820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7580 160TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550448348",
"telephone_number": "952-898-1133",
"fax_number": "952-435-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "CINDY",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-23",
"last_updated": "2017-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "LAMFT 1536",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.