Individual provider Active NPI

Lynndelle Kristin Pratt, M.S., LMFT

  • Marriage & Family Therapist
  • Brooklyn Park, MN
National Provider Identifier
1073837795
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2004 Issued in MN
Practice address
7600 Boone Ave N
Suite 2
Brooklyn Park, MN 55428-4563
Phone
(763) 504-8458
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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 2004 MN Primary

Addresses

Primary practice location

7600 Boone Ave N
Suite 2
Brooklyn Park, MN 55428-4563

Mailing address

7600 Boone Ave N Ste 2
Brooklyn Park, MN 55428-1089
Phone (763) 504-8458

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
I20240507002600 MN Practitioner - Marriage and Family Therapist 1951742063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Innovations IncGroup PAC ID 6204178528, 96 clinicians

Practice addresses (Care Compare)

5353 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-1338
Phone (763) 421-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2004MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Innovations, Inc. Marriage & Family Therapist CurrentSince Mar 25, 2024 Accepting new patients
West Central Counseling LLC Marriage & Family Therapist PastSince Jun 6, 2021 Accepting new patients

Locations

121 5th Ave W
Alexandria, MN 56308
Phone (320) 759-3096

1833 3rd Ave
Anoka, MN 55303
Phone (763) 421-5535

2270 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000

2270 Ford Pkwy
Ste 106
Saint Paul, MN 55116
Phone (651) 724-9411

5353 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 281-5764

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1073837795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 BOONE AVE N STE 2",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554281089",
            "telephone_number": "763-504-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 BOONE AVE N",
            "address_2": "SUITE 2",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554284563",
            "telephone_number": "763-504-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "LYNNDELLE",
        "middle_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.