M&T Sisters of Serendipity PLLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

M&T SISTERS OF SERENDIPITY PLLC

Practice address

212A Centralave
Faribault, MN 55021

Phone

(507) 271-5089

NPI assigned

Nov 21, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Mallory Kate Fuchs, LADC

Title

Owner/Ceo

Phone

(507) 271-5089

Specialties & licenses 1

Addresses

Other names 1

• Refine Service Coordination, PLLC Former legal business name

Locations

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1053957357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 4TH ST SW",
            "city": "MEDFORD",
            "state": "MN",
            "postal_code": "55049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212A CENTRALAVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-271-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&T SISTERS OF SERENDIPITY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "FUCHS",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "KATE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "507-271-5089",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Refine Service Coordination, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Faribault, MN
• Providers in Faribault, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.